Five-Item Modified Frailty Index Score is Associated With Increased Postoperative Complications Following Ankle...

Area of Science:

• Orthopedic Surgery
• Geriatric Surgery
• Health Services Research

Background:

• Ankle fracture open reduction and internal fixation (ORIF) is a common orthopedic procedure.
• Patient frailty is increasingly recognized as a significant factor influencing surgical outcomes.
• The 5-factor modified frailty index (mFI-5) is a validated tool for assessing patient frailty.

Purpose of the Study:

• To evaluate the predictive value of the preoperative 5-factor modified frailty index (mFI-5) for 30-day outcomes after ankle fracture ORIF.
• To determine the association between mFI-5 scores and complication, readmission, reoperation, and mortality rates.
• To assess the utility of mFI-5 in identifying high-risk patients undergoing ankle fracture ORIF.

Main Methods:

• Retrospective cohort study utilizing the American College of Surgeons (ACS NSQIP) database.
• Inclusion of 44,938 patients who underwent ankle fracture ORIF.
• Stratification of patients into groups based on preoperative mFI-5 scores to analyze outcomes.

Main Results:

• The mFI-5 score significantly predicted various adverse outcomes, including any complication (P < .001), serious medical complication (P < .001), surgical site infection (P < .001), readmission (P < .001), reoperation (P < .001), and mortality (P < .001).
• Higher mFI-5 scores were associated with increased likelihood of adverse discharge (P < .001) and longer hospital length of stay (LOS) (P < .001).
• The study cohort comprised predominantly males (59.0%) with a mean age of 49.52 years.

Conclusions:

• The preoperative 5-factor modified frailty index (mFI-5) is a valuable tool for predicting 30-day postoperative complications, adverse discharge, readmission, reoperation, mortality, and increased LOS in patients undergoing ankle fracture ORIF.
• Utilizing mFI-5 can help orthopedic surgeons identify at-risk patients and potentially optimize preoperative management strategies.
• This retrospective cohort study (Level III evidence) highlights the importance of frailty assessment in surgical decision-making for ankle fractures.