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Modified Frailty Index Predicts Postoperative Outcomes in Patients Undergoing Radical Pelvic Surgery
Patients undergoing radical pelvic surgery such as proctectomy or radical cystectomy are at risk of experiencing a variety of complications. Frailty renders patients vulnerable to adverse events. We hypothesize that frailty measured preoperatively using a validated scoring system correlates with inc...
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| Published in: | The American surgeon 2020-02, Vol.86 (2), p.95-103 |
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| Main Authors: | , , , , |
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| Language: | English |
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| cited_by | cdi_FETCH-LOGICAL-c371t-67ccf29d25ac7531a243f911710b42f47e95fb46f55423618602a3621194b8e73 |
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| cites | cdi_FETCH-LOGICAL-c371t-67ccf29d25ac7531a243f911710b42f47e95fb46f55423618602a3621194b8e73 |
| container_end_page | 103 |
| container_issue | 2 |
| container_start_page | 95 |
| container_title | The American surgeon |
| container_volume | 86 |
| creator | Mcchesney, Shannon L. Canter, Daniel J. Monlezun, Dominique J. Green, Heather Margolin, David A. |
| description | Patients undergoing radical pelvic surgery such as proctectomy or radical cystectomy are at risk of experiencing a variety of complications. Frailty renders patients vulnerable to adverse events. We hypothesize that frailty measured preoperatively using a validated scoring system correlates with increased likelihood of experiencing Clavien-Dindo grade IV complications and 30-day mortality and may be used as a predictive model for patients preoperatively. The NSQIP database was queried for patients who underwent proctectomy or radical cystectomy from 2008 to 2012. Pre-operative frailty was calculated using the 11-point modified frailty index (MFI). Patients were scored based on the presence of indicators and categorized into two groups ( |
| doi_str_mv | 10.1177/000313482008600222 |
| format | article |
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Frailty renders patients vulnerable to adverse events. We hypothesize that frailty measured preoperatively using a validated scoring system correlates with increased likelihood of experiencing Clavien-Dindo grade IV complications and 30-day mortality and may be used as a predictive model for patients preoperatively. The NSQIP database was queried for patients who underwent proctectomy or radical cystectomy from 2008 to 2012. Pre-operative frailty was calculated using the 11-point modified frailty index (MFI). Patients were scored based on the presence of indicators and categorized into two groups (<3 or ≥3). Major postoperative morbidities and mortality were identified and analyzed in each group. 10,048 proctectomy and cystectomy patients were identified. The MFI was found to be predictive of both 30-day mortality (P < 0.0001) and Clavien-Dindo grade IV complications (P < 0.0001). Receiver operating characteristic analysis demonstrated improved discriminative power of the MFI with the addition of American Society of Anesthesiologists class for both prediction of complications and 30-day mortality. An MFI score of ≥3 is predictive of postoperative morbidity and mortality. Providers should be encouraged to calculate frailty preoperatively to predict adverse outcomes.</description><identifier>ISSN: 0003-1348</identifier><identifier>EISSN: 1555-9823</identifier><identifier>DOI: 10.1177/000313482008600222</identifier><identifier>PMID: 32167059</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Adolescent ; Adult ; Aged ; Aged, 80 and over ; Case-Control Studies ; Coma ; Complications ; Correlation analysis ; Cystectomy - adverse effects ; Cystectomy - mortality ; Cystectomy - statistics & numerical data ; Databases, Factual ; Female ; Frailty ; Frailty - complications ; Frailty - diagnosis ; Frailty - mortality ; Humans ; Male ; Medical personnel ; Middle Aged ; Morbidity ; Mortality ; Patients ; Pelvis - surgery ; Postoperative Complications - diagnosis ; Postoperative Complications - etiology ; Postoperative Complications - mortality ; Postoperative Period ; Prediction models ; Predictive Value of Tests ; Proctectomy - adverse effects ; Proctectomy - mortality ; Proctectomy - statistics & numerical data ; Retrospective Studies ; ROC Curve ; Surgery ; Treatment Outcome ; Variables ; Young Adult</subject><ispartof>The American surgeon, 2020-02, Vol.86 (2), p.95-103</ispartof><rights>2020 Southeastern Surgical Congress</rights><rights>Copyright Southeastern Surgical Congress Feb 2020</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c371t-67ccf29d25ac7531a243f911710b42f47e95fb46f55423618602a3621194b8e73</citedby><cites>FETCH-LOGICAL-c371t-67ccf29d25ac7531a243f911710b42f47e95fb46f55423618602a3621194b8e73</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32167059$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mcchesney, Shannon L.</creatorcontrib><creatorcontrib>Canter, Daniel J.</creatorcontrib><creatorcontrib>Monlezun, Dominique J.</creatorcontrib><creatorcontrib>Green, Heather</creatorcontrib><creatorcontrib>Margolin, David A.</creatorcontrib><title>Modified Frailty Index Predicts Postoperative Outcomes in Patients Undergoing Radical Pelvic Surgery</title><title>The American surgeon</title><addtitle>Am Surg</addtitle><description>Patients undergoing radical pelvic surgery such as proctectomy or radical cystectomy are at risk of experiencing a variety of complications. Frailty renders patients vulnerable to adverse events. We hypothesize that frailty measured preoperatively using a validated scoring system correlates with increased likelihood of experiencing Clavien-Dindo grade IV complications and 30-day mortality and may be used as a predictive model for patients preoperatively. The NSQIP database was queried for patients who underwent proctectomy or radical cystectomy from 2008 to 2012. Pre-operative frailty was calculated using the 11-point modified frailty index (MFI). Patients were scored based on the presence of indicators and categorized into two groups (<3 or ≥3). Major postoperative morbidities and mortality were identified and analyzed in each group. 10,048 proctectomy and cystectomy patients were identified. The MFI was found to be predictive of both 30-day mortality (P < 0.0001) and Clavien-Dindo grade IV complications (P < 0.0001). Receiver operating characteristic analysis demonstrated improved discriminative power of the MFI with the addition of American Society of Anesthesiologists class for both prediction of complications and 30-day mortality. An MFI score of ≥3 is predictive of postoperative morbidity and mortality. Providers should be encouraged to calculate frailty preoperatively to predict adverse outcomes.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Case-Control Studies</subject><subject>Coma</subject><subject>Complications</subject><subject>Correlation analysis</subject><subject>Cystectomy - adverse effects</subject><subject>Cystectomy - mortality</subject><subject>Cystectomy - statistics & numerical data</subject><subject>Databases, Factual</subject><subject>Female</subject><subject>Frailty</subject><subject>Frailty - complications</subject><subject>Frailty - diagnosis</subject><subject>Frailty - mortality</subject><subject>Humans</subject><subject>Male</subject><subject>Medical personnel</subject><subject>Middle Aged</subject><subject>Morbidity</subject><subject>Mortality</subject><subject>Patients</subject><subject>Pelvis - surgery</subject><subject>Postoperative Complications - diagnosis</subject><subject>Postoperative Complications - etiology</subject><subject>Postoperative Complications - mortality</subject><subject>Postoperative Period</subject><subject>Prediction models</subject><subject>Predictive Value of Tests</subject><subject>Proctectomy - adverse effects</subject><subject>Proctectomy - mortality</subject><subject>Proctectomy - statistics & numerical data</subject><subject>Retrospective Studies</subject><subject>ROC Curve</subject><subject>Surgery</subject><subject>Treatment Outcome</subject><subject>Variables</subject><subject>Young Adult</subject><issn>0003-1348</issn><issn>1555-9823</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><recordid>eNp90ctKAzEUBuAgitbqC7iQgBs3o7lnZiniDSoWL-shzZwpKdNJTWaKfXtTWhUUXIWE7z_JyUHohJILSrW-JIRwykXOCMkVIYyxHTSgUsqsyBnfRYM1yNbiAB3GOEtboSTdRwecUaWJLAaoevSVqx1U-DYY13Qr_NBW8IHHASpnu4jHPnZ-AcF0bgn4qe-sn0PErsXjdARtIm8pEabetVP8bFLKNHgMzdJZ_NKHKYTVEdqrTRPheLsO0dvtzev1fTZ6unu4vhpllmvaZUpbW7OiYtJYLTk1TPC6SK1SMhGsFhoKWU-EqqUUjCuammaGK0ZpISY5aD5E55u6i-Dfe4hdOXfRQtOYFnwfS8a15rygeZ7o2S86831o0-vWSgpFNFVJsY2ywccYoC4Xwc1NWJWUlOsZlH9nkEKn29L9ZA7Vd-Tr0xO43IBopvBz7z8lPwEZhYze</recordid><startdate>20200201</startdate><enddate>20200201</enddate><creator>Mcchesney, Shannon L.</creator><creator>Canter, Daniel J.</creator><creator>Monlezun, Dominique J.</creator><creator>Green, Heather</creator><creator>Margolin, David A.</creator><general>SAGE Publications</general><general>SAGE PUBLICATIONS, INC</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>4T-</scope><scope>4U-</scope><scope>7QL</scope><scope>7RV</scope><scope>7T7</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88I</scope><scope>8AF</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>C1K</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>M2P</scope><scope>M7N</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>S0X</scope><scope>7X8</scope></search><sort><creationdate>20200201</creationdate><title>Modified Frailty Index Predicts Postoperative Outcomes in Patients Undergoing Radical Pelvic Surgery</title><author>Mcchesney, Shannon L. ; Canter, Daniel J. ; Monlezun, Dominique J. ; Green, Heather ; Margolin, David A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c371t-67ccf29d25ac7531a243f911710b42f47e95fb46f55423618602a3621194b8e73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Case-Control Studies</topic><topic>Coma</topic><topic>Complications</topic><topic>Correlation analysis</topic><topic>Cystectomy - adverse effects</topic><topic>Cystectomy - mortality</topic><topic>Cystectomy - statistics & numerical data</topic><topic>Databases, Factual</topic><topic>Female</topic><topic>Frailty</topic><topic>Frailty - complications</topic><topic>Frailty - diagnosis</topic><topic>Frailty - mortality</topic><topic>Humans</topic><topic>Male</topic><topic>Medical personnel</topic><topic>Middle Aged</topic><topic>Morbidity</topic><topic>Mortality</topic><topic>Patients</topic><topic>Pelvis - surgery</topic><topic>Postoperative Complications - diagnosis</topic><topic>Postoperative Complications - etiology</topic><topic>Postoperative Complications - mortality</topic><topic>Postoperative Period</topic><topic>Prediction models</topic><topic>Predictive Value of Tests</topic><topic>Proctectomy - adverse effects</topic><topic>Proctectomy - mortality</topic><topic>Proctectomy - statistics & numerical data</topic><topic>Retrospective Studies</topic><topic>ROC Curve</topic><topic>Surgery</topic><topic>Treatment Outcome</topic><topic>Variables</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mcchesney, Shannon L.</creatorcontrib><creatorcontrib>Canter, Daniel J.</creatorcontrib><creatorcontrib>Monlezun, Dominique J.</creatorcontrib><creatorcontrib>Green, Heather</creatorcontrib><creatorcontrib>Margolin, David A.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Docstoc</collection><collection>University Readers</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>ProQuest Nursing and Allied Health Journals</collection><collection>Industrial and Applied Microbiology Abstracts (Microbiology A)</collection><collection>Virology and AIDS Abstracts</collection><collection>ProQuest Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>Consumer Health Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest Research Library</collection><collection>Science Database (ProQuest)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>SIRS Editorial</collection><collection>MEDLINE - Academic</collection><jtitle>The American surgeon</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mcchesney, Shannon L.</au><au>Canter, Daniel J.</au><au>Monlezun, Dominique J.</au><au>Green, Heather</au><au>Margolin, David A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Modified Frailty Index Predicts Postoperative Outcomes in Patients Undergoing Radical Pelvic Surgery</atitle><jtitle>The American surgeon</jtitle><addtitle>Am Surg</addtitle><date>2020-02-01</date><risdate>2020</risdate><volume>86</volume><issue>2</issue><spage>95</spage><epage>103</epage><pages>95-103</pages><issn>0003-1348</issn><eissn>1555-9823</eissn><abstract>Patients undergoing radical pelvic surgery such as proctectomy or radical cystectomy are at risk of experiencing a variety of complications. Frailty renders patients vulnerable to adverse events. We hypothesize that frailty measured preoperatively using a validated scoring system correlates with increased likelihood of experiencing Clavien-Dindo grade IV complications and 30-day mortality and may be used as a predictive model for patients preoperatively. The NSQIP database was queried for patients who underwent proctectomy or radical cystectomy from 2008 to 2012. Pre-operative frailty was calculated using the 11-point modified frailty index (MFI). Patients were scored based on the presence of indicators and categorized into two groups (<3 or ≥3). Major postoperative morbidities and mortality were identified and analyzed in each group. 10,048 proctectomy and cystectomy patients were identified. The MFI was found to be predictive of both 30-day mortality (P < 0.0001) and Clavien-Dindo grade IV complications (P < 0.0001). Receiver operating characteristic analysis demonstrated improved discriminative power of the MFI with the addition of American Society of Anesthesiologists class for both prediction of complications and 30-day mortality. An MFI score of ≥3 is predictive of postoperative morbidity and mortality. Providers should be encouraged to calculate frailty preoperatively to predict adverse outcomes.</abstract><cop>Los Angeles, CA</cop><pub>SAGE Publications</pub><pmid>32167059</pmid><doi>10.1177/000313482008600222</doi><tpages>9</tpages></addata></record> |
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| source | SAGE:Jisc Collections:SAGE Journals Read and Publish 2023-2024:2025 extension (reading list) |
| subjects | Adolescent Adult Aged Aged, 80 and over Case-Control Studies Coma Complications Correlation analysis Cystectomy - adverse effects Cystectomy - mortality Cystectomy - statistics & numerical data Databases, Factual Female Frailty Frailty - complications Frailty - diagnosis Frailty - mortality Humans Male Medical personnel Middle Aged Morbidity Mortality Patients Pelvis - surgery Postoperative Complications - diagnosis Postoperative Complications - etiology Postoperative Complications - mortality Postoperative Period Prediction models Predictive Value of Tests Proctectomy - adverse effects Proctectomy - mortality Proctectomy - statistics & numerical data Retrospective Studies ROC Curve Surgery Treatment Outcome Variables Young Adult |
| title | Modified Frailty Index Predicts Postoperative Outcomes in Patients Undergoing Radical Pelvic Surgery |
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