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Modified Frailty Index Predicts Complication Risk Following Laparoscopic Common Bile Duct Exploration
Aashish Rajesh1, David Limon1, Prem Patel1
1Department of Surgery, University of Texas Health San Antonio, San Antonio, Texas.
The Journal of Surgical Research
|June 15, 2026
Summary
The 5-factor modified frailty index (mFI-5) effectively predicts complications after laparoscopic common bile duct exploration (LCBDE). A higher mFI-5 score indicates increased risk for adverse outcomes, aiding in preoperative risk stratification.
Area of Science:
- Surgical outcomes research
- Patient risk stratification
Background:
- Frailty, assessed by the 5-factor modified frailty index (mFI-5), is linked to poor outcomes after surgery.
- Laparoscopic common bile duct exploration (LCBDE) is a common procedure for common bile duct stones.
Purpose of the Study:
- To evaluate the 5-factor modified frailty index (mFI-5) as a predictor of postoperative outcomes in patients undergoing laparoscopic common bile duct exploration (LCBDE).
Main Methods:
- Analysis of the National Surgical Quality Improvement Project dataset (2018-2022).
- Inclusion of 1725 patients who underwent laparoscopic common bile duct exploration (LCBDE).
- Assessment of risk factors, mFI-5 scores, and postoperative outcomes.
Main Results:
- Higher mFI-5 scores correlated with increased all-cause and infectious complications, reoperation, readmission, and longer hospital stays.
- mFI-5 score did not predict 30-day postoperative mortality.
- mFI-5 thresholds of ≥1 and ≥2 were superior in predicting complications compared to ≥3.
Conclusions:
- The 5-factor modified frailty index (mFI-5) is a valuable tool for predicting complications after laparoscopic common bile duct exploration (LCBDE).
- mFI-5 enables efficient preoperative risk stratification.
- Thresholds of mFI-5 ≥1 or ≥2 are suitable for risk assessment, with ≥2 potentially reducing false positives.
