V. Pandit1, M. Zeeshan1, S. Jhajj1, A. Lee1, K. R. Goshima1, C. Weinkauf1, W. Zhou1, T. Tan1 1University Of Arizona,Department Of Surgery,Tucson, AZ, USA
Introduction:
The modified frailty index (mFI-11) is a NSQIP-based 11-factor index that has been proven to adequately reflect frailty and predict mortality and morbidity. In past years, certain NSQIP variables have been removed from the database; as of 2015, only 5 of the original 11 factors remained. The predictive power and usefulness of these 5 factors in an index (mFI-5) have not been proven in patients undergoing endovascular repair (EVAR) of abdominal aortic aneurysm (AAA). The goal of our study was to compare the mFI-5 to the mFI-11 in terms of value and predictive ability for mortality, postoperative infection, and unplanned 30-day readmission.
Methods:
The mFI was calculated by dividing the number of factors present for a patient by the number of available factors for which there were no missing data. Spearman's rho test was used to assess correlation between the mFI-5 and mFI-11. Predictive models, using both unadjusted and adjusted logistic regressions, were created for each outcome for EVAR using 2005-2012 NSQIP data, the last year all mFI-11 variables existed.
Results:
A total of 14,387 patients were included. Mean age was 71.6±6.5. Overall, 22.1% patients were frail. A total of 24.1% had in-hospital complications, while 4.9% patients died. Correlation between the mFI-5 and mFI-11 was above 0.9 across all outcomes for patients undergoing EVAR. Adjusted and unadjusted models showed similar c-statistics for mFI-5 and mFI-11, and strong predictive ability for mortality, postoperative complications and 30-days readmission (Table 1).
Conclusion:
The mFI-5 and the mFI-11 are equally effective predictors of postoperative outcomes in patients undergoing endovascular aneurysm repair of abdominal aortic aneurysm and the mFI-5 is a strong predictor of postoperative complications, mortality and 30-d readmission. It has credibility for future use to study frailty within the NSQIP database. It also has potential in other databases and for clinical use.
