Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, New York, USA.
Breast J. 2021 Jun;27(6):509-513. doi: 10.1111/tbj.14208. Epub 2021 Mar 1.
Understanding the risk factors that contribute to post-mastectomy complications can better inform preoperative discussions. Here, we assess the impact of the 5-Factor Frailty Index Score (mFI-5) in predicting 30-day postoperative complications in patients undergoing mastectomy. A retrospective review of the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) data base was conducted for patients older than 65 undergoing mastectomy between 2010 and 2015. We assessed each patient's Frailty Index Score using the mFI-5. Primary outcomes included wound complications and overall complications. Multivariate logistic and linear regression analyses were used to determine the ability of the mFI-5 to predict postoperative outcomes. A total of 13,783 patients were analyzed. The rate of wound complications was 3.0%, while the rate of overall complications was 6.0%. An mFI-5 score greater than 2 was an independent risk factor for wound complications and overall complications. Overall, patients undergoing mastectomy with an mFI-5 of 2 or greater experienced higher rates of postoperative complications. The mFI-5 is an accessible tool that can be used to risk-stratify patients undergoing mastectomy and can positively contribute to the informed consent and shared decision-making process.
了解导致乳房切除术后并发症的风险因素可以更好地指导术前讨论。在这里，我们评估了 5 因素衰弱指数评分（mFI-5）在预测接受乳房切除术的患者 30 天术后并发症方面的影响。对美国外科医师学会国家手术质量改进计划（ACS-NSQIP）数据库中 2010 年至 2015 年间年龄大于 65 岁接受乳房切除术的患者进行了回顾性分析。我们使用 mFI-5 评估每位患者的衰弱指数评分。主要结局包括伤口并发症和总体并发症。多变量逻辑回归和线性回归分析用于确定 mFI-5 预测术后结局的能力。共分析了 13783 例患者。伤口并发症发生率为 3.0%，总并发症发生率为 6.0%。mFI-5 评分大于 2 是伤口并发症和总并发症的独立危险因素。总体而言，mFI-5 为 2 或更高的接受乳房切除术的患者经历了更高的术后并发症发生率。mFI-5 是一种易于使用的工具，可以对接受乳房切除术的患者进行风险分层，并可以为知情同意和共同决策过程做出积极贡献。
