Complications - OtherNew 5-Factor Modified Frailty Index Predicts Morbidity and Mortality in Primary Hip and Knee Arthroplasty
Section snippets
Methods
The checklist of Haider et al [15] for the elevation of surgical database research was used throughout the design of this study. The ACS NSQIP database was selected as the most appropriate for evaluating this hypothesis. The NSQIP is a national database that collects patient data from over 600 participating hospitals. Patient demographics and their perioperative course from the date of surgery to postop day 30 is included in the database. The data are then deidentified before being shared with
Total Hip Arthroplasty
One hundred forty thousand one hundred fifty-eight patients undergoing primary total hip arthroplasty (THA) between the years 2005 and 2016 were identified. Patient characteristics are outlined in Table 1. The average patient age was 64.8 years, and 55.2% were male. Most patients had an ASA class of 2 or 3, at 53.3% and 40.5%, and a BMI between 18.5 and 34.9 (Table 1).
Baseline complication rates were calculated for all patients undergoing THA (n = 140,158, Table 2). The overall risk for any
Discussion
This is the first study to examine the utility of the mFI-5 in patients undergoing total hip and knee arthroplasty. These results suggest that the mFI-5 is an effective tool for predicting complications including life-threatening medical complications, surgical site infections, readmission, and mortality in this patient population.
Previous studies looking solely at the mFI-11 in this patient population have concluded similar results [12], [13], [14]. In a study by Shin et al [12], 39,806
Conclusions
This study demonstrates that the mFI-5 is an effective predictor of morbidity and mortality in patients undergoing total hip and knee arthroplasty. This clinical tool can be used by hospitals and surgeons to identify high-risk surgical candidates and guide preoperative counseling in order to optimize patient outcomes.
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One or more of the authors of this paper have disclosed potential or pertinent conflicts of interest, which may include receipt of payment, either direct or indirect, institutional support, or association with an entity in the biomedical field which may be perceived to have potential conflict of interest with this work. For full disclosure statements refer to https://doi.org/10.1016/j.arth.2018.09.040.