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.

The authors sought to determine whether 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 1 institution. mFI-5 scores were calculated for each patient. Thirty-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.

Four hundred and seventy-four patients were stratified into 3 age groups: 15 to 30, 31 to 50, and >51. Twenty-six percent of patients developed 1 wound-healing problem. On univariate analysis, ages 31 to 50 and 51+ (odds ratio [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 >51 years significantly predicted wound-healing issues (OR = 2.89; P = .001) when controlled for the American Society of Anesthesiologists (ASA) score, smoking, and BMI. The mFI-5 did not significantly predict wound-healing issues when controlled for age, ASA, BMI, or smoking.

In the study 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.

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