Age-Adjusted Modified Frailty Index Predicts 30-Day Complications and Mortality in Aseptic Revision Total Hip and Knee Arthroplasty

Ryan S. Zamanzadeh; Jesse Seilern und Aspang; Andrew M. Schwartz; J. Ryan Martin; Ajay Premkumar; Jacob M. Wilson

doi:10.1016/j.arth.2023.06.032

Age-Adjusted Modified Frailty Index Predicts 30-Day Complications and Mortality in Aseptic Revision Total Hip and Knee Arthroplasty

Ryan S. Zamanzadeh, Jesse Seilern und Aspang, Andrew M. Schwartz, J. Ryan Martin, Ajay Premkumar Jacob M. Wilson

The Journal of arthroplasty, Vol.39(1), pp.198-205

01/2024

: 10.1016/j.arth.2023.06.032

The age-adjusted modified frailty index (aamFI) has been demonstrated to effectively predict postoperative complications and healthcare resource utilization in patients undergoing primary total joint arthroplasty. The purpose of this study was to evaluate the applicability of aamFI in patients undergoing aseptic revision total hip (rTHA) and knee arthroplasty (rTKA). A national database was queried for patients undergoing aseptic rTHA and rTKA from 2015 to 2020. A total of 13,307 rTHA and 18,762 rTKA cases were identified. The aamFI was calculated by adding one additional point for age ≥73-years to the previously described 5-item modified frailty index (mFI-5). The area under the curve was calculated and compared to compare predictive accuracy between mFI-5 and aamFI. Logistic regression was used to investigate the relationship between aamFI and 30-day complications. The incidence of incurring any (≥1) complication increased from 15% for aamFI 0 to 45% for aamFI ≥5 after rTHA and from 5 to 55% after rTKA. Patients who had an aamFI ≥3 (reference aamFI=0) had increased odds (rTHA: odds ratio (OR) 3.5, 95% confidence interval (CI) 2.9-4.1, P<.001; rTKA: OR 4.2, 95% CI 4.4-5.1, P<.001) of incurring at least one complication. The aamFI, compared to mFI-5, was a more accurate predictor of any complication (rTHA P<.001; rTKA P<.001) and 30-day mortality (rTHA P<.001; rTKA P<.003). The aamFI is an excellent predictor of complications in patients undergoing rTHA and rTKA. The addition of chronological age to the previously described mFI-5 improves the predictive value of this simple metric.

age

Frailty

postoperative complications

resource utilization

revision total hip arthroplasty

revision total knee arthroplasty

: Age-Adjusted Modified Frailty Index Predicts 30-Day Complications and Mortality in Aseptic Revision Total Hip and Knee Arthroplasty
: Ryan S. Zamanzadeh - Emory University
Jesse Seilern und Aspang - Emory University School of Medicine
Andrew M. Schwartz - University of Iowa
J. Ryan Martin - Vanderbilt University Medical Center
Ajay Premkumar - Hospital for Special Surgery
Jacob M. Wilson - Vanderbilt University Medical Center
: Journal article
: The Journal of arthroplasty, Vol.39(1), pp.198-205
: Elsevier Inc
: 10.1016/j.arth.2023.06.032
: 0883-5403
: 1532-8406
: English
: 06/26/2023
: 01/2024
: Orthopedics and Rehabilitation
: 9984438804302771