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The 5-Factor Modified Frailty Index Predicts Complications, Hospital Admission, and Mortality Following Arthroscopic Rotator Cuff Repair.
Arthroscopy. 2019 Dec 31 [Online ahead of print]A

Abstract

INTRODUCTION

The purpose of this study is to evaluate the utility of the modified frailty index-5 (mFI-5) as a predictor for postoperative complications in patients undergoing arthroscopic rotator cuff repair (RCR).

METHODS

The National Surgical Quality Improvement Program database was queried for patients undergoing arthroscopic RCR between 2006 and 2016. The mFI-5, a 5-factor score comprising comorbid diabetes, hypertension, congestive heart failure, chronic obstructive pulmonary disease, and functional status limiting independence, was calculated for each patient. Multivariate logistic regression models were used to evaluate the mFI-5 score as a predictor for complications including medical complications, surgical-site infections, hospital admission, discharge to a facility, and mortality.

RESULTS

In total, 24,477 patients met criteria for inclusion. The mFI-5 was a strong predictor for medical complications (P < .001), hospital admission (P < .001), length of stay (P = .007), and discharge to a facility (P = .001) but not surgical-site infections (P = .153). For each point increase in mFI-5 score, the risk for a medical complication increased by 66%, readmission by 52%, and adverse discharge by 45%. However, of all the measured complications, the mFI-5 was the strongest predictor for mortality, with the risk more than doubling for each increase in mFI-5 point (odds ratio 2.66, P = .025).

CONCLUSIONS

The mFI-5 is a sensitive tool for predicting life-threatening medical complications, hospital admission, increased length of stay, adverse discharge, and mortality following arthroscopic RCR. The 5 comorbidities comprising the mFI-5 are easily obtained through the patient history, making it a practical clinical tool for identifying high-risk patients, informing preoperative counseling, and improving value-based health care.

LEVEL OF EVIDENCE

Level III, prognostic.

Authors+Show Affiliations

Department of Orthopaedics, Medical University of South Carolina, Charleston, South Carolina, U.S.A.. Electronic address: traven@musc.edu.Department of Orthopaedics, Medical University of South Carolina, Charleston, South Carolina, U.S.A.Department of Medicine, University of Maryland Medical Center, Baltimore, Maryland, U.S.A.Department of Orthopaedics, Medical University of South Carolina, Charleston, South Carolina, U.S.A.Department of Orthopaedics, Medical University of South Carolina, Charleston, South Carolina, U.S.A.Department of Orthopaedics, Medical University of South Carolina, Charleston, South Carolina, U.S.A.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31901389

Citation

Traven, Sophia A., et al. "The 5-Factor Modified Frailty Index Predicts Complications, Hospital Admission, and Mortality Following Arthroscopic Rotator Cuff Repair." Arthroscopy : the Journal of Arthroscopic & Related Surgery : Official Publication of the Arthroscopy Association of North America and the International Arthroscopy Association, 2019.
Traven SA, Horn RW, Reeves RA, et al. The 5-Factor Modified Frailty Index Predicts Complications, Hospital Admission, and Mortality Following Arthroscopic Rotator Cuff Repair. Arthroscopy. 2019.
Traven, S. A., Horn, R. W., Reeves, R. A., Walton, Z. J., Woolf, S. K., & Slone, H. S. (2019). The 5-Factor Modified Frailty Index Predicts Complications, Hospital Admission, and Mortality Following Arthroscopic Rotator Cuff Repair. Arthroscopy : the Journal of Arthroscopic & Related Surgery : Official Publication of the Arthroscopy Association of North America and the International Arthroscopy Association. https://doi.org/10.1016/j.arthro.2019.08.036
Traven SA, et al. The 5-Factor Modified Frailty Index Predicts Complications, Hospital Admission, and Mortality Following Arthroscopic Rotator Cuff Repair. Arthroscopy. 2019 Dec 31; PubMed PMID: 31901389.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The 5-Factor Modified Frailty Index Predicts Complications, Hospital Admission, and Mortality Following Arthroscopic Rotator Cuff Repair. AU - Traven,Sophia A, AU - Horn,Ryan W, AU - Reeves,Russell A, AU - Walton,Zeke J, AU - Woolf,Shane K, AU - Slone,Harris S, Y1 - 2019/12/31/ PY - 2019/04/12/received PY - 2019/06/29/revised PY - 2019/08/20/accepted PY - 2020/1/6/entrez JF - Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association JO - Arthroscopy N2 - INTRODUCTION: The purpose of this study is to evaluate the utility of the modified frailty index-5 (mFI-5) as a predictor for postoperative complications in patients undergoing arthroscopic rotator cuff repair (RCR). METHODS: The National Surgical Quality Improvement Program database was queried for patients undergoing arthroscopic RCR between 2006 and 2016. The mFI-5, a 5-factor score comprising comorbid diabetes, hypertension, congestive heart failure, chronic obstructive pulmonary disease, and functional status limiting independence, was calculated for each patient. Multivariate logistic regression models were used to evaluate the mFI-5 score as a predictor for complications including medical complications, surgical-site infections, hospital admission, discharge to a facility, and mortality. RESULTS: In total, 24,477 patients met criteria for inclusion. The mFI-5 was a strong predictor for medical complications (P < .001), hospital admission (P < .001), length of stay (P = .007), and discharge to a facility (P = .001) but not surgical-site infections (P = .153). For each point increase in mFI-5 score, the risk for a medical complication increased by 66%, readmission by 52%, and adverse discharge by 45%. However, of all the measured complications, the mFI-5 was the strongest predictor for mortality, with the risk more than doubling for each increase in mFI-5 point (odds ratio 2.66, P = .025). CONCLUSIONS: The mFI-5 is a sensitive tool for predicting life-threatening medical complications, hospital admission, increased length of stay, adverse discharge, and mortality following arthroscopic RCR. The 5 comorbidities comprising the mFI-5 are easily obtained through the patient history, making it a practical clinical tool for identifying high-risk patients, informing preoperative counseling, and improving value-based health care. LEVEL OF EVIDENCE: Level III, prognostic. SN - 1526-3231 UR - https://www.unboundmedicine.com/medline/citation/31901389/The_5_Factor_Modified_Frailty_Index_Predicts_Complications_Hospital_Admission_and_Mortality_Following_Arthroscopic_Rotator_Cuff_Repair_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0749-8063(19)30756-X DB - PRIME DP - Unbound Medicine ER -
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