A modified frailty index predicts complication, readmission, and 30-day mortality following the revision total hip arthroplasty.

IF 2.3 4区医学 Q2 ORTHOPEDICS

Arthroplasty Pub Date : 2024-02-04 DOI:10.1186/s42836-024-00232-8

David Momtaz, Shawn Okpara, Armando Martinez, Tucker Cushing, Abdullah Ghali, Rishi Gonuguntla, Travis Kotzur, Anthony Duruewuru, Madison Harris, Ali Seifi, Melvyn Harrington

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Abstract

Introduction: This study aimed to develop a modified frailty index (MFI) to predict the risks of revision total hip arthroplasty (THA).

Methods: Data from the American College of Surgeons - National Surgical Quality Improvement Program were analyzed for patients who underwent revision THA from 2015 to 2020. An MFI was composed of the risk factors, including severe obesity (body mass index > 35), osteoporosis, non-independent function status prior to surgery, congestive heart failure within 30 days of surgery, hypoalbuminemia (serum albumin < 3.5), hypertension requiring medication, type 1 or type 2 diabetes, and a history of chronic obstructive pulmonary disease or pneumonia. The patients were assigned based on the MFI scores (MFI0, no risk factor; MFI1, 1-2 risk factors; MFI2, 3-4 risk factors; and MFI3, 5+ risk factors). Confidence intervals were set at 95% with a P value less than or equal to 0.05 considered statistically significant.

Results: A total of 17,868 patients (45% male, 55% female) were included and had an average age of 68.5 ± 11.5 years. Odds of any complication, when compared to MFI0, were 1.4 (95% CI [1.3, 1.6]) times greater for MFI1, 3.2 (95% CI [2.8, 3.6]) times greater for MFI2, and 10.8 (95% CI [5.8, 20.0]) times greater for MFI3 (P < 0.001). Odds of readmission, when compared to MFI0, were 1.4 (95% CI [1.3, 1.7]) times greater for MFI1, 2.5 (95% CI [2.1, 3.0]) times greater for MFI2, and 4.1 (95% CI [2.2, 7.8]) times greater for MFI3 (P < 0.001).

Conclusion: Increasing MFI scores correlate with increased odds of complication and readmission in patients who have undergone revision THA. This MFI may be used to predict the risks after revision THA.

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改良虚弱指数可预测翻修全髋关节置换术后的并发症、再入院和 30 天死亡率。

简介：本研究旨在开发一种改良虚弱指数（MFI），用于预测全髋关节置换术（THA）的翻修风险：本研究旨在开发一种改良虚弱指数（MFI），用于预测翻修全髋关节置换术（THA）的风险：方法：分析了美国外科医生学会--国家外科质量改进计划（National Surgical Quality Improvement Program）在2015年至2020年期间对接受翻修全髋关节置换术的患者进行的数据。MFI由风险因素组成，包括严重肥胖（体重指数大于35）、骨质疏松症、术前非独立功能状态、术后30天内充血性心力衰竭、低白蛋白血症（血清白蛋白小于3.5）、需要药物治疗的高血压、1型或2型糖尿病以及慢性阻塞性肺病或肺炎病史。根据 MFI 评分对患者进行分配（MFI0，无风险因素；MFI1，1-2 个风险因素；MFI2，3-4 个风险因素；MFI3，5 个以上风险因素）。置信区间设定为 95%，P 值小于或等于 0.05 视为具有统计学意义：共纳入 17,868 名患者（男性占 45%，女性占 55%），平均年龄为 68.5 ± 11.5 岁。与 MFI0 相比，MFI1 发生任何并发症的几率是其 1.4（95% CI [1.3，1.6]）倍，MFI2 是其 3.2（95% CI [2.8，3.6]）倍，MFI3 是其 10.8（95% CI [5.8，20.0]）倍（P < 0.001）。与 MFI0 相比，MFI1 的再入院几率为 1.4（95% CI [1.3，1.7]）倍，MFI2 为 2.5（95% CI [2.1，3.0]）倍，MFI3 为 4.1（95% CI [2.2，7.8]）倍（P <0.001）：结论：MFI评分的增加与接受翻修THA的患者发生并发症和再入院的几率增加有关。该 MFI 可用于预测翻修后 THA 的风险。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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