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Related Experiment Video

Updated: Sep 13, 2025

Author Spotlight: Assessing Surgical Frailty with Point-of-Care Ultrasound of Quadriceps Muscles
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Author Spotlight: Assessing Surgical Frailty with Point-of-Care Ultrasound of Quadriceps Muscles

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Risk Analysis Index Versus Modified Frailty Index: Outcomes After Otolaryngologic Surgery.

Lauran K Evans1, Carine Tamamian2, Desiree Delavary3

  • 1Department of Head and Neck Surgery, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, California, USA.

The Laryngoscope
|August 1, 2025
PubMed
Summary
This summary is machine-generated.

The Clinical Risk Analysis Index (RAI-C) better predicts postoperative outcomes in otolaryngology surgery than the Modified 5-Item Frailty Index (MFI-5). RAI-C is recommended for frailty research and patient care planning.

Keywords:
MFI‐5RAI‐Cfrailtypostoperative complicationssurgical outcomes

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Area of Science:

  • Otolaryngology
  • Geriatric Medicine
  • Surgical Outcomes Research

Background:

  • Patient frailty significantly impacts postsurgical outcomes.
  • The Modified 5-Item Frailty Index (MFI-5) and Clinical Risk Analysis Index (RAI-C) are common frailty assessment tools.
  • A direct comparison of these indices in otolaryngology has not been previously conducted.

Purpose of the Study:

  • To compare the predictive performance of MFI-5 and RAI-C for postsurgical outcomes in otolaryngology.
  • To determine which frailty index is superior for identifying patients at risk of adverse events after head and neck surgery.

Main Methods:

  • Retrospective chart review of 1209 patients undergoing otolaryngologic surgery.
  • Utilized chi-square analysis and Receiver Operating Characteristic (ROC) curves to assess predictive abilities.
  • Compared MFI-5 and RAI-C in predicting postoperative complications and 30-day readmissions.

Main Results:

  • RAI-C identified 23% of patients as frail, while MFI-5 identified 21%.
  • RAI-C predicted a 5.7-fold increased odds of postoperative complications (p < 0.0001), whereas MFI-5 did not.
  • Both indices predicted 30-day readmission similarly (AUC ~0.76-0.77), but RAI-C showed superior prediction for other outcomes.

Conclusions:

  • The RAI-C demonstrated superior predictive performance for postoperative outcomes compared to MFI-5 in otolaryngology surgery.
  • RAI-C assessment is valuable for frailty research, treatment planning, and managing patient expectations.
  • Findings support the integration of RAI-C into routine clinical practice for at-risk surgical populations.