Department of Orthopaedic Surgery, School of Medicine and Health Sciences, The George Washington University, 2300 I St NW, Washington, DC, 20052, USA.
Department of Orthopaedic Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Eur J Orthop Surg Traumatol. 2024 Aug;34(6):3281-3287. doi: 10.1007/s00590-024-04070-x. Epub 2024 Aug 13.
The 5-item modified frailty index (mFI-5) has been established as a reliable indicator of poor postoperative outcomes following a variety of orthopaedic procedures. This study aims to determine whether the mFI-5 can be used by surgeons to predict the likelihood of postoperative complications in patients undergoing open reduction internal fixation (ORIF) for tibial plateau fractures.
From 2006 to 2019, patients aged 50 years or older undergoing ORIF for tibial plateau fracture were identified in the National Surgical Quality Improvement Program database. The mFI-5 was calculated based on the sum of the presence of 5 conditions: diabetes, congestive heart failure, hypertension, chronic obstructive pulmonary disease, and dependent functional status. Chi-squared tests and multivariable regression analysis were used to evaluate the association of different mFI-5 scores with postoperative complications.
The study analyzed 2213 patients with an average age of 63 years. Multivariable regression analysis demonstrated that in comparison to patients with a mFI-5 score of 0, those with a score of 1 had an increased risk of prolonged hospital stay (OR 1.31) and discharge to a non-home location (OR 1.50) while those with a score of 2 or greater were at an increased risk of readmission (OR 2.30), wound complication (OR 5.37), pulmonary complication (OR 4.56), urinary tract infection (OR 4.79), prolonged hospital stay (OR 1.89), and discharge to a non-home location (OR 3.01).
The mFI-5 is a reliable instrument for determining the likelihood of postoperative complications following ORIF for tibial plateau fracture repair.
III.
五项修正虚弱指数（mFI-5）已被确立为多种骨科手术后不良术后结局的可靠指标。本研究旨在确定外科医生是否可以使用 mFI-5 来预测接受胫骨平台骨折切开复位内固定术（ORIF）的患者发生术后并发症的可能性。
在 2006 年至 2019 年期间，从国家手术质量改进计划数据库中确定了 50 岁或以上接受胫骨平台骨折 ORIF 的患者。mFI-5 是根据存在以下 5 种情况的总和计算得出的：糖尿病、充血性心力衰竭、高血压、慢性阻塞性肺疾病和依赖功能状态。卡方检验和多变量回归分析用于评估不同 mFI-5 评分与术后并发症的关系。
该研究分析了 2213 名平均年龄为 63 岁的患者。多变量回归分析表明，与 mFI-5 评分为 0 的患者相比，评分为 1 的患者住院时间延长（OR 1.31）和出院至非家庭地点（OR 1.50）的风险增加，而评分为 2 或更高的患者再次入院（OR 2.30）、伤口并发症（OR 5.37）、肺部并发症（OR 4.56）、尿路感染（OR 4.79）、住院时间延长（OR 1.89）和出院至非家庭地点（OR 3.01）的风险增加。
mFI-5 是确定胫骨平台骨折修复后 ORIF 术后并发症可能性的可靠工具。
III 级。
