Predicting Complications Following Patella Fracture Repair Using the 5-Item Modified Frailty Index.

Background: Several studies have found the 5-item modified frailty index (mFI-5) to be a reliable indicator of poor postoperative outcomes following various surgical procedures. This study aims to evaluate whether the mFI-5 continues to serve as a reliable predictor for patients undergoing patella fracture repair.

Methods: The NSQIP database was queried to identify patients ages 50 or older who underwent surgery for patella fractures between 2006-2019. The mFI-5 was calculated based on the presence of the following 5 comorbidities: diabetes, CHF, hypertension, COPD, and dependent functional status. Frailty scores were stratified based on number of comorbidities: mFI-5 = 0, 1, and ≥ 2. Bivariate and multivariate analyses were used to compare the complication rates among the mFI-5 scores.

Results: A total of 2,917 patients with an average age of 67 years were included. As the mFI-5 score increased from 0 to 1, patients had an increased risk of readmission (OR 2.94), reoperation (OR 2.15), urinary tract infection (OR 3.49), and discharge to a non-home location (OR 1.41). In addition to these risks, patients with a score of 2 or greater also had an increased risk of mortality (OR 4.40), wound (OR 3.37), pulmonary (OR 8.69), and sepsis complication (OR 5.58), bleeding requiring transfusion (OR 4.56), and length of stay > 7 days (OR 2.48) when compared with patients with a score of 0.

Conclusion: Increasing mFI-5 scores were significantly associated with increased morbidity and mortality following patella fracture repair. Level of Evidence: III.