Higher Modified Frailty Index Score is Associated with Increased 30-Day Postoperative Complications Following Surgical Treatment of Tibial Shaft Fractures

Document Type : RESEARCH PAPER

Authors

1 Washington University School of Medicine, St. Louis, MO, USA

2 George Washington School of Medicine and Health Sciences, Washington, DC, USA

3 Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA

4 Department of Orthopaedic Surgery, Johns Hopkins Hospital, Baltimore, BA, USA

Abstract

Objectives: This study was conducted to determine if factors comprising the mFI were correlated with 
adverse outcomes following surgical intervention of tibial shaft fractures.
Methods: We identified patients 50 years or older with tibial shaft fractures that were managed surgically from a 
national database from 2007-2019. The 5-item mFI score, which comprised of diabetes, hypertension, congestive 
heart failure, dependent functional status, and chronic obstructive pulmonary disease, was calculated for each 
patient. Regression analysis was used to evaluate the association of different mFI scores with thirty-day 
postoperative outcomes.
Results: 1,159 total patients (mean age of 65 years) were included in this study. After controlling for confounding 
variables on multivariate analysis, compared to patients with a mFI of 0, those with a score of 1 had an increased 
risk of major complications (OR 5.11; p=0.038), minor complications (OR 3.11; p=0.004), readmission (OR 2.75; 
p=0.020), postoperative transfusion (OR 2.22; p=0.037), prolonged hospital stay (OR 1.88; p<0.001), and non-home 
discharge (OR 1.52; p=0.014). Similar increased risk of complications was seen for patients with a mFI of 2 
compared to those with a score of 0: major complications (OR 9.49; p=0.004), readmission (OR 3.73; p=0.003), 
postoperative transfusion (OR 4.07; p<0.001), prolonged hospital stay (OR 2.50; p<0.001), and non-home discharge 
(OR 2.32; p<0.001).
Conclusion: Higher scores on the mFI were associated with higher complication rates in patients following surgical 
treatment of tibial shaft fractures. The modified frailty index is a useful tool for surgeons to assess risk before 
operation.
 Level of evidence: III

Keywords

Main Subjects

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The Archives of Bone and Joint Surgery
Volume 12, Issue 9
September 2024
Pages 637-644

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History

  • Receive Date: 06 October 2023
  • Revise Date: 10 July 2024
  • Accept Date: 15 June 2024

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