Predicting Postoperative Complications in Oncoplastic Surgery Using the Modified Frailty Index

Area of Science:

• Oncoplastic surgery
• Surgical oncology
• Patient outcomes

Background:

• Preoperative evaluation is vital for breast cancer patients undergoing oncoplastic surgery.
• The Modified 5-item Frailty Index (mFI) is a validated tool for predicting postoperative complications.
• This study assesses the mFI's utility in the context of oncoplastic breast cancer surgery.

Purpose of the Study:

• To evaluate the effectiveness of the Modified 5-item Frailty Index (mFI) in predicting postoperative complications in breast cancer patients undergoing oncoplastic surgery.
• To determine the association between mFI scores and specific types of complications, including overall, medical, and wound complications.

Main Methods:

• Analysis of data from the National Surgical Quality Improvement Program database (2005-2020).
• Inclusion of breast cancer patients who underwent oncoplastic surgery.
• Stratification of patients based on mFI scores (0, 1, and ≥2) and multivariate logistic regression to identify risk factors for complications.

Main Results:

• Higher mFI scores (≥2) were associated with increased rates of overall complications (7.7%), medical complications (1.7%), and wound complications (4.4%).
• Multivariate analysis confirmed mFI ≥2 as a significant risk factor for overall (OR=1.67), medical (OR=5.24), and wound complications (OR=1.73).
• No significant difference in outcomes was observed between patients with mFI 0 and mFI 1.

Conclusions:

• An mFI score of 2 or greater is a strong predictor of increased overall, medical, and wound complications following oncoplastic breast cancer surgery.
• Patients with an mFI score of 1 experience similar outcomes to those with an mFI score of 0.
• Preoperative counseling and tailored management strategies are recommended for patients with high mFI scores (≥2).