The Modified 5-Item Frailty Index is a Predictor of Perioperative Complications in Digital Replantation.

IF 1.8 Q2 ORTHOPEDICS

HAND Pub Date : 2025-09-18 DOI:10.1177/15589447251366678

Thor S Stead, Neel Vishwanath, Nikhil Sobti, Tareq Kheirbek, Amy C Kite

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引用次数: 0

Abstract

Background: Digit replantation has a significant risk of postoperative complications including an estimated reoperation rate around 14%. This study evaluates the modified frailty index 5 (mFI-5) in predicting postoperative complications including reoperation for digit replantation.

Methods: The American College of Surgeons' National Surgical Quality Improvement Program database (2007-2019) was queried to identify patients who underwent upper extremity blood vessel repair distal to the wrist. Demographics, patient characteristics, mFI-5 scores, and all complications, including reoperation and readmission, were analyzed using univariate and multivariate analyses to identify associations between mFI-5 and complications.

Results: We identified 1336 patients who underwent digit replantation. Of those, 99 patients (7.4%) had mFI-5 ≥ 3. Frail patients were defined as having mFI-5 ≥ 3 based on prior literature. Higher mFI-5 scores correlated with increased rates of all-cause complications (mFI-5 ≥ 3: 51.5% vs mFI-5 = 0: 9.2%, P < .001), readmission (mFI-5 ≥ 3: 15.8% vs mFI-5 = 0: 2.2%, P < .001), and reoperation (mFI-5 ≥ 3: 8.8% vs mFI-5 = 0: 3.1%, P < .001). Multivariate analysis indicated that an mFI-5 score ≥ 3 significantly increased the rates of any complication (odds ratio [OR] = 9.1, 95% confidence interval [CI], 3.9-21.2, P < .001), mortality (OR = 5.4, 95% CI, 1.1-27.0, P = .04), surgical complications (OR = 7.5, 95% CI, 2.5-22.9, P < .001), and medical complications (OR = 13.4, 95% CI, 3.9-46.7, P < .001). These patients also had lower odds of home discharge (OR = 0.35, 95% CI, 0.22-0.56, P < .001) and higher odds of unplanned readmission (OR = 1.4, 95% CI, 1.3-1.5, P < .001) compared with those with mFI-5 = 0.

Conclusions: The mFI-5 is an effective tool for predicting adverse outcomes in digit replantation. It is simple to calculate preoperatively and aids in risk stratification, perioperative counseling, operative planning, and postoperative outcomes.

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改良的5项衰弱指数是数字再植围手术期并发症的预测指标。

背景：手指再植有明显的术后并发症风险，估计再手术率约为14%。本研究评估改良虚弱指数5 （mFI-5）在预测手指再植术后并发症中的应用价值。方法：查询美国外科医师学会国家外科质量改进计划数据库（2007-2019），以确定腕部远端接受上肢血管修复的患者。采用单因素和多因素分析分析人口统计学、患者特征、mFI-5评分和所有并发症，包括再手术和再入院，以确定mFI-5与并发症之间的关系。结果：我们确定了1336例接受手指再植术的患者。其中99例（7.4%）患者mFI-5≥3。根据既往文献，虚弱患者定义为mFI-5≥3。较高的mFI-5评分与全因并发症发生率（mFI-5≥3:51.5% vs mFI-5 = 0.9.2%, P < 0.001）、再入院率（mFI-5≥3:15.8% vs mFI-5 = 0.2.2%, P < 0.001）和再手术率（mFI-5≥3:8.8% vs mFI-5 = 0.3.1%, P < 0.001）相关。多因素分析显示，mFI-5评分≥3分显著增加并发症发生率（优势比[OR] = 9.1, 95%可信区间[CI]， 3.9-21.2, P < .001）、死亡率（OR = 5.4, 95% CI, 1.1-27.0, P = .04）、手术并发症发生率（OR = 7.5, 95% CI, 2.5-22.9, P < .001）和内科并发症发生率（OR = 13.4, 95% CI, 3.9-46.7, P < .001）。与mFI-5 = 0的患者相比，这些患者出院的几率较低（OR = 0.35, 95% CI, 0.22-0.56, P < .001），意外再入院的几率较高（OR = 1.4, 95% CI, 1.3-1.5, P < .001）。结论：mFI-5是预测手指再植术不良后果的有效工具。术前计算简便，有助于风险分层、围手术期咨询、手术计划和术后预后。

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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来源期刊

HAND Medicine-Surgery

CiteScore

3.30

自引率

0.00%

发文量

209

期刊介绍： HAND is the official journal of the American Association for Hand Surgery and is a peer-reviewed journal featuring articles written by clinicians worldwide presenting current research and clinical work in the field of hand surgery. It features articles related to all aspects of hand and upper extremity surgery and the post operative care and rehabilitation of the hand.