The following is a summary of “Role of mFI-5 in predicting geriatric outcomes in laparoscopic cholecystectomy,” published in the November 2023 issue of Surgery by Agathis, et al.
Frailty, characterized by age-related decline and increased vulnerability to adverse outcomes, is a significant factor in surgical outcomes among older people. For a study, researchers sought to evaluate the predictive capability of the modified 5-factor frailty index (mFI-5) for outcomes in geriatric patients undergoing cholecystectomy.
Patients aged 65 and above who underwent laparoscopic cholecystectomy were identified from the American College of Surgeons’ National Surgical Quality Improvement Program database spanning 2018–2020. The mFI-5 includes variables such as hypertension, congestive heart failure, chronic obstructive pulmonary disease, diabetes, and functional status. Patients were grouped based on the number of comorbidities: mFI = 0, mFI = 1, mFI≥2.
The study included 32,481 cases, with 27.6% having mFI = 0, 46.4% with mFI = 1, and 26.0% with mFI≥2. The highest frailty levels were correlated with an increased likelihood of discharges to locations other than home (OR 1.88, P < 0.01). Non-independent functional status was associated with mortality (OR 7.32), prolonged length of stay (LOS) (5.69), pneumonia (4.90), sepsis (3.78), and readmission (2.60) (P < 0.01). The area under the curve (AUC) values were calculated for prolonged LOS (0.89), discharges to not home (0.85), mortality (0.83), pneumonia (0.76), and sepsis (0.76).
The mFI-5 is a valuable tool for healthcare teams to identify at-risk cholecystectomy patients and proactively intervene to prevent complications. The index can aid in targeted care strategies to enhance outcomes for elderly patients undergoing cholecystectomy.
Reference: americanjournalofsurgery.com/article/S0002-9610(23)00373-2/fulltext