V. Pandit1, M. Zeeshan2, T. Tan2, S. Jhajj2, V. Horst1, K. Kempe1, W. Zhou2, P. Nelson1 1University of Oklahoma,Vascular Surgery,Tulsa, OK, USA 2University Of Arizona,Vascular Surgery,Tucson, AZ, USA
Introduction: Frailty syndrome is an established predictor of adverse outcomes after surgical procedures. The aim of our study was to compare the newer National Surgical Quality Improvement Program (NSQIP) 5-factor modified frailty index (mFI-5) to its prior 11-factor modified frailty index (mFI-11) with respect to their predictive ability for mortality, postoperative complications, and unplanned 30-day readmission in patients undergoing lower limb amputation.
Methods: The ACS-NSQIP (2005-2012) databank was queried for all geriatric patients (>65y) who underwent lower limb amputation. We calculated the mFI by dividing the number of factors present for a patient by the number of available factors. To assess the correlation between the mFI-5 and mFI-11 we used the Spearman's rho. We then compared the two indices for each outcome and C-Statistic using predictive models
Results:A total of 8,681 patients were included with mean age was 76±9 years, complication rate 35.8%, and mortality rate 10.2%, and readmission rate is 15.9%. Correlation between the mFI-5 and mFI-11 was above 0.9 across all outcomes for patients. mFI-5 had strong predictive ability for mortality, postoperative complications and 30-days readmission
Conclusion:In patients undergoing lower limb amputation, we found mFI-5 and the mFI-11 were equally effective in predicting postoperative outcomes. Frailty remained a strong predictor of postoperative complications, mortality and 30-d readmission.
