Evaluating the Use of 5-Factor Modified Frailty Index to Predict Wound Healing Complications in Reduction Mammoplasty

Reduction mammoplasty is an established treatment for symptomatic macromastia. Understanding risk factors associated with complications is essential for counseling and patient selection. The modified frailty index (mFI-5) has been proposed as a simple tool to assess risk in surgical candidates.

We sought to determine if the mFI-5 can accurately predict wound healing complications following reduction mammoplasty.

A retrospective review was performed of primary bilateral reduction mammoplasty cases between 2017 and 2019 at one institution. MFI-5 scores were calculated for each patient. 30-day wound healing complications were defined as incisional dehiscence, T-point breakdown, nipple-areolar complex necrosis, and fat necrosis. Univariate and multivariate logistic regression were used to evaluate predictive value.

474 patients were stratified into three age groups: 15-30, 31-50, and over 51. Twenty-six percent of patients developed 1 wound healing problem. On univariate analysis, ages 31-50 and 51+ (OR 2.75 and 3.16) and mFI score of 1 (OR 2.07) were associated with an increased risk of wound healing complications. Adjusted multivariate analysis indicated that age greater than 51 years significantly predicted wound healing issues (OR 2.89; p=0.001) when controlled for American Society of Anesthesiologists (ASA) score, smoking, and body mass index (BMI). The mFI-5 did not significantly predict wound healing issues when controlled for age, ASA, BMI, or smoking.

In our population, the mFI-5 was not a statistically significant predictor of wound healing complications following reduction mammoplasty. When controlling for confounders, advanced age alone seems to place patients at higher risk for wound healing complications.