Raju Rinu, Singh Pooja, Mandal Pranita, Waindeskar Vaishali, Karna Sunaina Tejpal
Department of Anesthesiology, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India.
Indian J Anaesth. 2025 Jul;69(7):693-699. doi: 10.4103/ija.ija_903_24. Epub 2025 Jun 12.
Modified frailty index (mFI) is a valuable tool for predicting postoperative complications (POCs). We aimed to determine the association of frailty using mFI and the technique of anaesthesia, with POCs as the primary outcomes in patients undergoing non-malignant abdominal surgeries under general or neuraxial anaesthesia.
After ethical approval, 125 patients of either gender, aged ≥18 years and scheduled to undergo general or neuraxial anaesthesia were enroled. Preoperatively, the mFI score was calculated for all the patients. Patients with mFI ≥0.27 were considered 'significantly frail'. The patients were followed up from the immediate postoperative period to 30 days after surgery, and POCs as per the Clavien-Dindo (CD) classification during their hospital stay were recorded. After discharge, patients were followed up telephonically every 15 days within 30 days to monitor for readmission or mortality.
The sensitivity and specificity of the mFI score to predict major POC were 86.11% and 88.76%, respectively, with a high negative predictive value of 94.05%. In mFI scores ≤0.27 and ≥0.27, the odds of POC were 1.74 and 2.33 times higher with general anaesthesia than with neuraxial anaesthesia, respectively. In mFI ≥0.27, the odds of 30-day readmission were 29.04 (95% confidence interval: 6.26, 34.68) with a longer hospital stay ( < 0.001).
Higher mFI scores consistently predict more severe postoperative complications, particularly in CD grades II and IV and intensive care unit. The anaesthesia technique showed no significant association with postoperative complications, except in the higher mFI group.
改良虚弱指数（mFI）是预测术后并发症（POC）的一项重要工具。我们旨在确定在接受全身麻醉或神经轴索麻醉的非恶性腹部手术患者中，使用mFI评估的虚弱状况与麻醉技术和POC之间的关联，以POC作为主要结局指标。
经伦理批准后，纳入125例年龄≥18岁、计划接受全身麻醉或神经轴索麻醉的患者，无论性别。术前计算所有患者的mFI评分。mFI≥0.27的患者被视为“显著虚弱”。对患者从术后即刻至术后30天进行随访，记录住院期间根据Clavien-Dindo（CD）分类的POC。出院后，在30天内每15天通过电话随访患者，以监测再入院或死亡情况。
mFI评分预测主要POC的敏感性和特异性分别为86.11%和88.76%，阴性预测值高达94.05%。在mFI评分≤0.27和≥0.27的患者中，全身麻醉组发生POC的几率分别比神经轴索麻醉组高1.74倍和2.33倍。在mFI≥0.27的患者中，30天再入院几率为29.04（95%置信区间：6.26，34.68），住院时间更长（P<0.001）。
较高的mFI评分始终能预测更严重的术后并发症，尤其是在CD分级II级和IV级以及重症监护病房的患者中。除了在mFI较高的组中，麻醉技术与术后并发症无显著关联。
