The purpose of researchers was to determine if gynecologic cancer patients who undergo surgery have a higher risk of postoperative problems, readmissions, or discharge locations other than a home using the 5-factor modified frailty index (mFI). Using the National Surgical Quality Improvement Program (NSQIP) database, investigators were able to locate women who had surgery for gynecologic cancer (cervical, uterine, or ovarian cancer) between 2014 and 2018. Patients were divided into 6 groups using the 5-factor mFI (mFI groups 0, 1, 2, 3, 4, and 5). Complications, readmissions, and non-home discharge rates were all assessed after 30 days. The correlation between mFI category and readmissions/complications was calculated using multivariable logistic regression models. Study group derived an adjusted incident probability by factoring in patient variables. There were a total of 31,181 instances of gynecologic cancer included in the study; specifically, there were N=2,968 (9.4%) cases of cervical cancer, N=20,862 (66.4%) cases of uterine cancer, and N=7,351 (23.4%) cases of ovarian cancer. In total, 46.1% of patients fell into category 0, 36.5% into category 1, and 1% into categories 3-5 Older age, African American race, laparoscopic surgery, and obesity were all factors that were linked to higher mFI. Adjusted multivariable analysis revealed a dose-response connection between greater mFI and readmission and 30-day complications (adjusted OR 2.37 (1.65-3.45) for readmissions and 2.10 (1.59-2.75) for complications in mFI categories 3-5, respectively). These correlations were true across all cancer types studied. In patients with gynecologic cancer, the 5-factor mFI is a reliable predictor of readmissions, 30-day problems, and non-home release. Identifying patients for non-surgical treatments, prehabilitation, and short-term home assessments is possible by including mFI into a standard preoperative examination.
Source: sciencedirect.com/science/article/pii/S0090825822004358
