Modified Frailty Index Predicts Postoperative Complications Following Parastomal Hernia Repair

Mustafa Khan, Ronit Patnaik, Melinda Lue, Haisar Dao Campi, Lisandro Montorfano, Mauricio Sarmiento Cobos, Roberto J. Valera, Raul J. Rosenthal, Steven D. Wexner

Producción científica: Articlerevisión exhaustiva

1 Cita (Scopus)


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.

Idioma originalEnglish (US)
Páginas (desde-hasta)207-215
Número de páginas9
PublicaciónAmerican Surgeon
EstadoPublished - feb 2024

ASJC Scopus subject areas

  • Surgery


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