Journal article
The Age-Adjusted Modified Frailty Index: An Improved Risk Stratification Tool for Patients Undergoing Primary Total Hip Arthroplasty
The Journal of arthroplasty, Vol.37(6), pp.1098-1104
06/2022
DOI: 10.1016/j.arth.2022.02.055
PMID: 35189289
Abstract
Frailty and increasing age are well-established risk factors in patients undergoing total hip arthroplasty (THA). However, these variables have only been considered independently. This study assesses the interplay between age and frailty and introduces a novel age-adjusted modified frailty index (aamFI) for more refined risk stratification of THA patients.
The American College of Surgeons National Surgical Quality Improvement Program database was queried from 2015 to 2019 for patients undergoing primary THA. First, outcomes were compared between chronologically younger and older frail patients. Then, to establish the aamFI, one additional point was added to the previously described mFI-5 for patients aged ≥73 years (the 75th percentile for age in our study population). The association of aamFI with postoperative complications and resource utilization was then analyzed categorically.
A total of 165,957 THA patients were evaluated. Older frail patients had a higher incidence of complications than younger frail patients. Regression analysis demonstrated a strong association between aamFI and complications. For instance, an aamFI of ≥3 (compared to aamFI of 0) was associated with an increased odds of mortality (OR: 22.01, 95% confidence interval [CI] 11.62-41.68), any complication (OR: 3.50, 95% CI 3.23-3.80), deep vein thrombosis (OR: 2.85, 95% CI 2.03-4.01), and nonhome discharge (OR 9.61, 95% CI 9.04-10.21; all P < .001).
Chronologically, older patients are impacted more by frailty than younger patients. The aamFI accounts for this and outperforms the mFI-5 in prediction of postoperative complications and resource utilization in patients undergoing primary THA.
Details
- Title: Subtitle
- The Age-Adjusted Modified Frailty Index: An Improved Risk Stratification Tool for Patients Undergoing Primary Total Hip Arthroplasty
- Creators
- Jesse Seilern Und Aspang - Department of Orthopaedic Surgery, Emory University School of Medicine, Atlanta, GeorgiaRyan S Zamanzadeh - Emory UniversityAndrew M Schwartz - Duke UniversityAjay Premkumar - Hospital for Special SurgeryJ Ryan Martin - Vanderbilt UniversityJacob M Wilson - Emory University
- Resource Type
- Journal article
- Publication Details
- The Journal of arthroplasty, Vol.37(6), pp.1098-1104
- DOI
- 10.1016/j.arth.2022.02.055
- PMID
- 35189289
- ISSN
- 0883-5403
- eISSN
- 1532-8406
- Language
- English
- Date published
- 06/2022
- Academic Unit
- Orthopedics and Rehabilitation
- Record Identifier
- 9984304719802771
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