Modified frailty index predicts early outcomes after colorectal surgery: an ACS‐NSQIP study

A. AL‐Khamis; C. Warner; J. Park; S. Marecik; N. Davis; A. Mellgren; J. Nordenstam; K. Kochar

doi:10.1111/codi.14725

journal article Jul 01, 2019

Modified frailty index predicts early outcomes after colorectal surgery: an ACS‐NSQIP study

A. AL‐Khamis C. Warner J. Park

S. Marecik N. Davis A. Mellgren J. Nordenstam K. Kochar

Colorectal Disease Vol. 21 No. 10 pp. 1192-1205 · Wiley

View at Publisher Save 10.1111/codi.14725

Abstract

AbstractAimFrailty is defined as a decrease in physiological reserve with increased risk of morbidity following significant physiological stressors. This study examines the predictive power of the five‐item modified frailty index (5‐mFI) in predicting outcomes in colorectal surgery patients.MethodsThe American College of Surgeons National Surgical Quality Improvement Program Database was queried from 2011 to 2016 to determine the predictive power of 5‐mFI in patients who had colorectal surgery.ResultsOf 295 490 patients, 45.8% had a score of 0, 36.2% had a score of 1 and 18% had a score of ≥ 2. On univariate analysis, frailer patients had significantly greater incidences for overall morbidity, serious morbidity, mortality, prolonged length of hospital stay, discharge to a facility other than home, reoperation and unplanned readmission. These findings were consistent on multivariate analysis where the frailest patients had greater odds of postoperative overall morbidity (OR 1.39; 95% CI 1.35–1.43), serious morbidity (OR 1.39; 95% CI 1.33–1.45), mortality (OR 2.00; 95% CI 1.87–2.14), prolonged length of hospital stay (OR 1.24; 95% CI 1.20–1.27), discharge destination to a facility other than home (OR 2.80; 95% CI 2.70–2.90), reoperation (OR 1.17; 95% CI 1.11–1.23) and unplanned readmission (OR 1.31; 95% CI 1.26–1.36). Weighted kappa statistics showed strong agreement between the 5‐mFI and 11‐mFI (kappa = 0.987, P < 0.001).ConclusionsThe 5‐mFI is a valid and easy to use predictor of 30‐day postoperative outcomes after colorectal surgery. This tool may guide the surgeon to proactively recognize frail patients to instigate interventions to optimize them preoperatively.

Topics

No keywords indexed for this article. Browse by subject →

References

35

[1]

10.1097/ta.0b013e3182542fab

[2]

10.1016/j.jamcollsurg.2006.08.026

[3]

10.1111/j.1532-5415.2005.53159.x

[4]

10.1161/01.cir.97.7.673

[5]

10.1097/dcr.0000000000000722

[6]

10.1016/j.jvs.2016.10.102

[7]

10.1007/s11695-014-1532-3

[8]

Frailty as a Predictor of Surgical Outcomes in Older Patients

Martin A. Makary, Dorry L. Segev, Peter J. Pronovost et al.

Journal of the American College of Surgeons 10.1016/j.jamcollsurg.2010.01.028

[9]

10.1097/01.dcr.0000442661.76345.f5

[10]

10.1097/ta.0b013e31824d0f70

[11]

Frailty predicts increased hospital and six-month healthcare cost following colorectal surgery in older adults

Thomas N. Robinson, Daniel S. Wu, Gregory V. Stiegmann et al.

The American Journal of Surgery 10.1016/j.amjsurg.2011.06.017

[12]

10.1097/mpa.0b013e318212c02c

[13]

10.1007/s00534-009-0116-4

[14]

10.1007/s00595-009-4112-8

[15]

10.1159/000073701

[16]

10.4240/wjgs.v8.i1.27

[17]

10.1016/j.jss.2014.07.004

[18]

10.1002/jso.24617

[19]

10.1100/tsw.2001.58

[20]

10.1016/j.jss.2013.01.021

[21]

10.1016/j.jss.2016.02.042

[22]

10.1016/j.ygyno.2015.01.532

[23]

10.1155/2017/5126452

[24]

10.1007/s00464-016-5253-7

[25]

10.1007/s11605-017-3641-5

[26]

10.1097/00000542-197810000-00003

[27]

10.1007/s10350-005-0185-7

[28]

10.1016/s0140-6736(02)09290-5

[29]

10.1007/s11605-007-0286-9

[30]

10.1001/jamasurg.2018.0214

[31]

10.1002/bjs.1800780327

[32]

10.1097/aln.0000000000000393

[33]

10.1002/bjs.1800740912

[34]

10.1002/bjs.1800730121

[35]

10.1007/s00384-009-0658-6

Cited By

92

Comparison of the prognostic value of MUST, ECOG-PS, mGPS and CT derived body composition analysis in patients with advanced lung cancer

Tanvir Abbass, Ross D. Dolan · 2020

Clinical Nutrition ESPEN

Metrics

92

Citations

35

References

Details

Published: Jul 01, 2019
Vol/Issue: 21(10)
Pages: 1192-1205
License: View

Authors

A

A. AL‐Khamis

Faculty of Medicine Division of Surgery Kuwait University Kuwait Kuwait; Division of Colon and Rectal Surgery Advocate Lutheran General Hospital Park Ridge Illinois USA

C

C. Warner

Division of Colon and Rectal Surgery University of Illinois at Chicago Chicago Illinois USA

J

J. Park

Division of Colon and Rectal Surgery Advocate Lutheran General Hospital Park Ridge Illinois USA

S

S. Marecik

Division of Colon and Rectal Surgery Advocate Lutheran General Hospital Park Ridge Illinois USA

N

N. Davis

Division of Colon and Rectal Surgery University of Illinois at Chicago Chicago Illinois USA

A

A. Mellgren

Division of Colon and Rectal Surgery University of Illinois at Chicago Chicago Illinois USA

J

J. Nordenstam

Division of Colon and Rectal Surgery University of Illinois at Chicago Chicago Illinois USA

K

K. Kochar

Division of Colon and Rectal Surgery Advocate Lutheran General Hospital Park Ridge Illinois USA

Cite This Article

A. AL‐Khamis, C. Warner, J. Park, et al. (2019). Modified frailty index predicts early outcomes after colorectal surgery: an ACS‐NSQIP study. Colorectal Disease, 21(10), 1192-1205. https://doi.org/10.1111/codi.14725

Modified frailty index predicts early outcomes after colorectal surgery: an ACS‐NSQIP study

You May Also Like