American journal of surgery · 2023
Role of mFI-5 in predicting geriatric outcomes in laparoscopic cholecystectomy.
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Agathis Alexandra Z, Bangla Venu G, Divino Celia M
Аннотация
BACKGROUND: Frailty is the age-related decline contributing to adverse outcome vulnerability. This study assesses the modified 5-factor frailty index's (mFI-5) ability to predict geriatric cholecystectomy outcomes.
METHODS: Laparoscopic cholecystectomy patients ages ≥65 were identified from the American College of Surgeons' National Surgical Quality Improvement Program database (2018-2020). MFI-5 variables include hypertension, congestive heart failure, chronic obstructive pulmonary disease, diabetes, and functional status. Groups were stratified according to the number of comorbidities: mFI = 0, mFI = 1, mFI≥2.
RESULTS: 32,481 cases included 27.6% mFI = 0, 46.4% mFI = 1, 26.0% mFI≥2. Highest frailty correlated with increased discharges to not home (OR 1.88, p < 0.01). Non-independent functional status was associated with mortality (OR 7.32), prolonged length of stay (LOS) (5.69), pneumonia (4.90), sepsis (3.78), readmission (2.60) (p < 0.01). AUCs were calculated for prolonged LOS (0.89), discharges to not home (0.85), mortality (0.83), pneumonia (0.76), sepsis (0.76).
CONCLUSIONS: Healthcare teams can use mFI-5 to target at-risk cholecystectomy patients and proactively intervene to avoid complications.
METHODS: Laparoscopic cholecystectomy patients ages ≥65 were identified from the American College of Surgeons' National Surgical Quality Improvement Program database (2018-2020). MFI-5 variables include hypertension, congestive heart failure, chronic obstructive pulmonary disease, diabetes, and functional status. Groups were stratified according to the number of comorbidities: mFI = 0, mFI = 1, mFI≥2.
RESULTS: 32,481 cases included 27.6% mFI = 0, 46.4% mFI = 1, 26.0% mFI≥2. Highest frailty correlated with increased discharges to not home (OR 1.88, p < 0.01). Non-independent functional status was associated with mortality (OR 7.32), prolonged length of stay (LOS) (5.69), pneumonia (4.90), sepsis (3.78), readmission (2.60) (p < 0.01). AUCs were calculated for prolonged LOS (0.89), discharges to not home (0.85), mortality (0.83), pneumonia (0.76), sepsis (0.76).
CONCLUSIONS: Healthcare teams can use mFI-5 to target at-risk cholecystectomy patients and proactively intervene to avoid complications.