Modified Frailty Index Predicts Postoperative Complications Following Parastomal Hernia Repair
BACKGROUND: The 5-factor frailty index (5-mFI), validated frailty index with Spearmen rho correlation of .95 and C statistic >.7 for predicting postoperative complications, can be preoperatively used to stratify patients prior to parastomal hernia repairs.
METHODS: Retrospective review of the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database identified patients from 2015 to 2020. 5-mFI scores were calculated by adding one point for each comorbidity present: diabetes mellitus, congestive heart failure (CHF), hypertension requiring medication, severe chronic obstructive pulmonary disease (COPD), non-independent functional status. Primary endpoint was 30-day overall complications; secondary endpoints were 30-day readmission, reoperation, and discharge to care facility.
RESULTS: 2924 (52.2% female) patients underwent elective parastomal hernia repair. Univariate analysis showed 5-mFI > 2 had higher rates of overall (P = .008), pulmonary (P = .002), cardiovascular (P = .003)), hematologic (P = .003), and renal (P = .002) complications and higher rates of readmission (P = .009), reoperation (P = .001), discharge to care facility (P < .001), and death (P < .001). Multivariate analysis identified a 5-mFI of 2 or more as an independent risk factor for overall complications [OR: 1.40, 1.03-1.78; P = .032], pulmonary complications [2.97, 1.63-5.39; P < .001], hematological complications [1.60, 1.03-2.47; P = .035], renal complications [2.04, 1.19-3.46; P = .009], readmission [1.54, 1.19-1.99; P < .001], and discharge to facility [2.50, 1.66-3.77; P < .001]. Reoperation was not signification on multivariate analysis.
CONCLUSIONS: Parastomal hernia repair patients with 5-mFI score of >2 had higher risk of renal, cardiovascular, pulmonary, and hematologic complications, readmissions, longer hospitalization, discharge to care facility, and mortality, and can be useful during preoperative risk stratification.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:90 |
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| Enthalten in: |
The American surgeon - 90(2024), 2 vom: 25. Jan., Seite 207-215 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Khan, Mustafa [VerfasserIn] |
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| Links: |
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| Themen: |
Journal Article |
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| Anmerkungen: |
Date Completed 19.01.2024 Date Revised 19.01.2024 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1177/00031348231198102 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM361308876 |
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| 100 | 1 | |a Khan, Mustafa |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Modified Frailty Index Predicts Postoperative Complications Following Parastomal Hernia Repair |
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| 500 | |a Date Revised 19.01.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a BACKGROUND: The 5-factor frailty index (5-mFI), validated frailty index with Spearmen rho correlation of .95 and C statistic >.7 for predicting postoperative complications, can be preoperatively used to stratify patients prior to parastomal hernia repairs | ||
| 520 | |a METHODS: Retrospective review of the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database identified patients from 2015 to 2020. 5-mFI scores were calculated by adding one point for each comorbidity present: diabetes mellitus, congestive heart failure (CHF), hypertension requiring medication, severe chronic obstructive pulmonary disease (COPD), non-independent functional status. Primary endpoint was 30-day overall complications; secondary endpoints were 30-day readmission, reoperation, and discharge to care facility | ||
| 520 | |a RESULTS: 2924 (52.2% female) patients underwent elective parastomal hernia repair. Univariate analysis showed 5-mFI > 2 had higher rates of overall (P = .008), pulmonary (P = .002), cardiovascular (P = .003)), hematologic (P = .003), and renal (P = .002) complications and higher rates of readmission (P = .009), reoperation (P = .001), discharge to care facility (P < .001), and death (P < .001). Multivariate analysis identified a 5-mFI of 2 or more as an independent risk factor for overall complications [OR: 1.40, 1.03-1.78; P = .032], pulmonary complications [2.97, 1.63-5.39; P < .001], hematological complications [1.60, 1.03-2.47; P = .035], renal complications [2.04, 1.19-3.46; P = .009], readmission [1.54, 1.19-1.99; P < .001], and discharge to facility [2.50, 1.66-3.77; P < .001]. Reoperation was not signification on multivariate analysis | ||
| 520 | |a CONCLUSIONS: Parastomal hernia repair patients with 5-mFI score of >2 had higher risk of renal, cardiovascular, pulmonary, and hematologic complications, readmissions, longer hospitalization, discharge to care facility, and mortality, and can be useful during preoperative risk stratification | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a modified frailty index | |
| 650 | 4 | |a national surgical quality improvement program | |
| 650 | 4 | |a parastomal hernia repair | |
| 650 | 4 | |a postoperative complications | |
| 650 | 4 | |a predictor | |
| 700 | 1 | |a Patnaik, Ronit |e verfasserin |4 aut | |
| 700 | 1 | |a Lue, Melinda |e verfasserin |4 aut | |
| 700 | 1 | |a Dao Campi, Haisar |e verfasserin |4 aut | |
| 700 | 1 | |a Montorfano, Lisandro |e verfasserin |4 aut | |
| 700 | 1 | |a Sarmiento Cobos, Mauricio |e verfasserin |4 aut | |
| 700 | 1 | |a Valera, Roberto J |e verfasserin |4 aut | |
| 700 | 1 | |a Rosenthal, Raul J |e verfasserin |4 aut | |
| 700 | 1 | |a Wexner, Steven D |e verfasserin |4 aut | |
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