Momtaz David, Okpara Shawn, Martinez Armando, Cushing Tucker, Ghali Abdullah, Gonuguntla Rishi, Kotzur Travis, Duruewuru Anthony, Harris Madison, Seifi Ali, Harrington Melvyn
Department of Orthopaedics, Baylor College of Medicine, Houston, TX, 77030, USA.
Arthroplasty. 2024 Feb 4;6(1):7. doi: 10.1186/s42836-024-00232-8.
This study aimed to develop a modified frailty index (MFI) to predict the risks of revision total hip arthroplasty (THA).
Data from the American College of Surgeons - National Surgical Quality Improvement Program were analyzed for patients who underwent revision THA from 2015 to 2020. An MFI was composed of the risk factors, including severe obesity (body mass index > 35), osteoporosis, non-independent function status prior to surgery, congestive heart failure within 30 days of surgery, hypoalbuminemia (serum albumin < 3.5), hypertension requiring medication, type 1 or type 2 diabetes, and a history of chronic obstructive pulmonary disease or pneumonia. The patients were assigned based on the MFI scores (MFI0, no risk factor; MFI1, 1-2 risk factors; MFI2, 3-4 risk factors; and MFI3, 5+ risk factors). Confidence intervals were set at 95% with a P value less than or equal to 0.05 considered statistically significant.
A total of 17,868 patients (45% male, 55% female) were included and had an average age of 68.5 ± 11.5 years. Odds of any complication, when compared to MFI0, were 1.4 (95% CI [1.3, 1.6]) times greater for MFI1, 3.2 (95% CI [2.8, 3.6]) times greater for MFI2, and 10.8 (95% CI [5.8, 20.0]) times greater for MFI3 (P < 0.001). Odds of readmission, when compared to MFI0, were 1.4 (95% CI [1.3, 1.7]) times greater for MFI1, 2.5 (95% CI [2.1, 3.0]) times greater for MFI2, and 4.1 (95% CI [2.2, 7.8]) times greater for MFI3 (P < 0.001).
Increasing MFI scores correlate with increased odds of complication and readmission in patients who have undergone revision THA. This MFI may be used to predict the risks after revision THA.
本研究旨在开发一种改良的衰弱指数（MFI）以预测全髋关节置换翻修术（THA）的风险。
分析了美国外科医师学会-国家外科质量改进计划中2015年至2020年接受THA翻修术患者的数据。MFI由以下风险因素组成，包括重度肥胖（体重指数>35）、骨质疏松症、术前非独立功能状态、术后30天内的充血性心力衰竭、低白蛋白血症（血清白蛋白<3.5）、需要药物治疗的高血压、1型或2型糖尿病以及慢性阻塞性肺疾病或肺炎病史。根据MFI评分对患者进行分组（MFI0，无风险因素；MFI1，1-2个风险因素；MFI2，3-4个风险因素；MFI3，5个及以上风险因素）。设定95%的置信区间，P值小于或等于0.05被认为具有统计学意义。
共纳入17868例患者（45%为男性，55%为女性），平均年龄为68.5±11.5岁。与MFI0相比，MFI1发生任何并发症的几率高1.4倍（95%置信区间[1.3,1.6]），MFI2高3.2倍（95%置信区间[2.8,3.6]），MFI3高10.8倍（95%置信区间[5.8,20.0]）（P<0.001）。与MFI0相比，MFI1再次入院的几率高1.4倍（95%置信区间[1.3,1.7]），MFI2高2.5倍（95%置信区间[2.1,3.0]），MFI3高4.1倍（95%置信区间[2.2,7.8]）（P<0.001）。
在接受THA翻修术的患者中，MFI评分增加与并发症和再次入院几率增加相关。这种MFI可用于预测THA翻修术后的风险。
