Seibold Bruce Tanner, Quan Theodore, Zhao Amy Y, Parel Philip M, Mikula Jacob D, Mun Frederick, Srikumaran Umasuthan, Zimmer Zachary R
Department of Orthopaedic Surgery, The George Washington University, Washington, DC, USA.
Department of Orthopaedic Surgery, Johns Hopkins University, Baltimore, MD, USA.
Shoulder Elbow. 2025 Jul;17(3):267-273. doi: 10.1177/17585732241229215. Epub 2024 Jan 31.
Previous studies have shown that increased 5-item modified frailty index (mFI-5) scores are associated with poor surgical outcomes. This study seeks to determine whether the comorbidities comprising the mFI-5 were correlated with poor outcomes following revision total shoulder arthroplasty (TSA).
Utilizing the National Surgical Quality Improvement Program database, a mFI-5 score was calculated for all patients 50 years and older who underwent revision TSA between 2013 and 2019. Pearson's Chi-squared tests and multivariable regression analysis were used to evaluate the association of the mFI score with various postoperative complications.
Patients with a mFI-5 score of 2+ had significantly increased risk of readmission (OR 2.58), bleeding requiring transfusion (OR 3.66), extended length of stay (OR 2.43), and discharge to a non-home destination (OR 3.22) compared to patients with a mFI-5 score of 0. Relative to patients with a score of 1, those with a mFI-5 score of 2+ had an increased risk of postoperative transfusion (OR 2.46), extended length of stay (OR 2.16), and discharge to a non-home location (OR 2.84).
The mFI-5 is a valuable tool that can stratify patients based on risk for postoperative complications following revision TSA.
既往研究表明,5项改良虚弱指数(mFI-5)评分升高与手术预后不良相关。本研究旨在确定构成mFI-5的合并症是否与翻修全肩关节置换术(TSA)后的不良预后相关。
利用国家外科质量改进计划数据库,为2013年至2019年间接受翻修TSA的所有50岁及以上患者计算mFI-5评分。采用Pearson卡方检验和多变量回归分析来评估mFI评分与各种术后并发症之间的关联。
与mFI-5评分为0的患者相比,mFI-5评分为2+的患者再入院风险显著增加(比值比[OR]2.58)、需要输血的出血风险(OR 3.66)、住院时间延长(OR 2.43)以及出院至非家庭目的地的风险(OR 3.22)。与评分为1的患者相比,mFI-5评分为2+的患者术后输血风险增加(OR 2.46)、住院时间延长(OR 2.16)以及出院至非家庭地点的风险(OR 2.84)。
mFI-5是一种有价值的工具,可根据翻修TSA术后并发症风险对患者进行分层。