Romina Deldar MD, Samuel S. Huffman BS, John D. Bovill BS, Nisha Gupta MS, Brian N. Truong BS, Zoë K. Haffner BS, Adaah A. Sayyed BS, Kenneth L. Fan MD, Karen K. Evans MD
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Patient characteristics, mFI-5, and postoperative outcomes were collected. Cohorts were divided by an mFI-5 score of <2 or ≥2.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>A total of 115 patients were identified, of which 71.3% (<i>n</i> = 82) were male, 64.3% (<i>n</i> = 74) had a mFI-5 score of ≥2, and 35.7% (<i>n</i> = 41) had a score <2. The average age and body mass index were 67.8 years and 28.7 kg/m<sup>2</sup>, respectively. The higher mFI-5 cohort had lower baseline albumin levels (3.0 vs. 4.0 g/dL, <i>p</i> = .015) and higher hemoglobin A1c levels (7.4 vs. 5.8%, <i>p</i> < .001). The postoperative length of stay was longer in the higher mFI-5 cohort (18 vs. 13.4 days, <i>p</i> = .003). The overall flap success was 96.5% (<i>n</i> = 111), with no difference between cohorts (<i>p</i> = .129). Postoperative complications were comparable between cohorts (<i>p</i> = .294). At a mean follow-up of 19.8 months, eight patients (7.0%) underwent amputation, and 91.3% (<i>n</i> = 105) were ambulatory.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>High microsurgical success rates can be achieved in comorbid patients with high frailty indexes who undergo FTT for limb salvage. A multidisciplinary team approach may effectively mitigate negative outcomes in elderly, frail patients.</p>\n </section>\n </div>","PeriodicalId":18600,"journal":{"name":"Microsurgery","volume":null,"pages":null},"PeriodicalIF":1.5000,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Clinical utility of the modified frailty index in predicting adverse outcomes in patients undergoing lower extremity free flap reconstruction\",\"authors\":\"Romina Deldar MD, Samuel S. Huffman BS, John D. Bovill BS, Nisha Gupta MS, Brian N. Truong BS, Zoë K. 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引用次数: 0
摘要
背景:在接受游离组织移植(FTT)以挽救肢体的慢性下肢(LE)创伤患者中,识别并发症高危患者仍具有挑战性。修正的 5 项虚弱指数(mFI-5)已被用于预测术后并发症,但尚未在该人群中进行过研究。本研究旨在确定 mFI-5 在预测术后不良后果方面的实用性:方法:对 2011 年至 2022 年期间在一家医疗机构接受 LE FTT 重建术的年龄≥60 岁的患者进行回顾性研究。收集患者特征、mFI-5和术后结果。按照 mFI-5 评分结果划分组群:共确定了115名患者,其中71.3%(n = 82)为男性,64.3%(n = 74)的mFI-5评分≥2分,35.7%(n = 41)的评分为2分。mFI-5 较高的人群基线白蛋白水平较低(3.0 vs. 4.0 g/dL,p = .015),血红蛋白 A1c 水平较高(7.4 vs. 5.8%,p 结论:mFI-5 较高的人群基线白蛋白水平较低(3.0 vs. 4.0 g/dL,p = .015),血红蛋白 A1c 水平较高(7.4 vs. 5.8%,p对于为挽救肢体而接受全髋关节置换术的虚弱指数较高的合并症患者,显微外科手术的成功率很高。多学科团队方法可有效减轻年老体弱患者的不良后果。
Clinical utility of the modified frailty index in predicting adverse outcomes in patients undergoing lower extremity free flap reconstruction
Background
Identifying at-risk patients for complications remains challenging in patients with chronic lower extremity (LE) wounds receiving free tissue transfer (FTT) for limb salvage. The modified-5 frailty index (mFI-5) has been utilized to predict postoperative complications, yet it has not been studied in this population. The aim of this study was to determine the utility of the mFI-5 in predicting adverse postoperative outcomes.
Methods
Patients ≥60 years, who underwent LE FTT reconstruction at a single institution from 2011 to 2022, were retrospectively reviewed. Patient characteristics, mFI-5, and postoperative outcomes were collected. Cohorts were divided by an mFI-5 score of <2 or ≥2.
Results
A total of 115 patients were identified, of which 71.3% (n = 82) were male, 64.3% (n = 74) had a mFI-5 score of ≥2, and 35.7% (n = 41) had a score <2. The average age and body mass index were 67.8 years and 28.7 kg/m2, respectively. The higher mFI-5 cohort had lower baseline albumin levels (3.0 vs. 4.0 g/dL, p = .015) and higher hemoglobin A1c levels (7.4 vs. 5.8%, p < .001). The postoperative length of stay was longer in the higher mFI-5 cohort (18 vs. 13.4 days, p = .003). The overall flap success was 96.5% (n = 111), with no difference between cohorts (p = .129). Postoperative complications were comparable between cohorts (p = .294). At a mean follow-up of 19.8 months, eight patients (7.0%) underwent amputation, and 91.3% (n = 105) were ambulatory.
Conclusion
High microsurgical success rates can be achieved in comorbid patients with high frailty indexes who undergo FTT for limb salvage. A multidisciplinary team approach may effectively mitigate negative outcomes in elderly, frail patients.
期刊介绍:
Microsurgery is an international and interdisciplinary publication of original contributions concerning surgery under microscopic magnification. Microsurgery publishes clinical studies, research papers, invited articles, relevant reviews, and other scholarly works from all related fields including orthopaedic surgery, otolaryngology, pediatric surgery, plastic surgery, urology, and vascular surgery.