Modified 5-Item Frailty Index and Postoperative Outcomes Following Parotidectomy for Malignancy.

Area of Science:

• Surgical Oncology
• Geriatric Surgery
• Health Services Research

Background:

• Frailty is a significant predictor of adverse outcomes in surgical patients.
• Parotidectomy for malignancy carries risks, and identifying vulnerable patients is crucial for optimizing care.

Purpose of the Study:

• To investigate the association between the modified 5-item frailty index (mFI-5) and postoperative outcomes in patients undergoing parotidectomy for malignancy.
• To determine if mFI-5 can aid in the risk stratification of patients undergoing this procedure.

Main Methods:

• Retrospective analysis of the 2005-2018 National Surgical Quality Improvement Program (NSQIP) database.
• Stratification of 14,567 patients undergoing parotidectomy for malignancy based on the mFI-5, calculated from five comorbidities.
• Univariate and multivariate analyses to assess the relationship between mFI-5 and patient characteristics, comorbidities, and postoperative complications.

Main Results:

• Increasing mFI-5 scores were associated with higher American Society of Anesthesiologists (ASA) class, increased comorbidities, and a greater incidence of complications (p < 0.001).
• Multivariable analysis revealed that an mFI-5 score ≥ 2 significantly increased the odds of any surgical complication (aOR 2.56), unplanned readmission (aOR 4.02), and reoperation (aOR 6.61) compared to an mFI-5 of 0.
• These associations remained significant and independent of age and ASA class.

Conclusions:

• The mFI-5 is a valuable tool for predicting increased comorbidities and postoperative complications, including surgical complications, unplanned readmissions, and reoperations, in patients undergoing parotidectomy for malignancy.
• The mFI-5 can be effectively used for risk stratification in this patient population, independent of age and ASA class.