Modified Fraility Index in Patients Undergoing Arthroplasty
Condition: Frailty Syndrome; Postoperative Complications
MeSH terms: Frailty; Postoperative Complications
Study type: Observational

Summary: 
      The authors aimed to evaluate the relation between Modified Fraility Index (MFI) and
      postoperative complications (myocardial infarction, cardiac arrest, pulmonary embolism,
      septic shock, postoperative dialysis requirement, cerebrovascular event, reintubation,
      prolonged mechanical ventilation, surgical wound complications), duration of hospitalization,
      requirement for intensive care unit (ICU) admission and rehospitalization and 30th day
      mortality in patients undergoing arthroplasy.
    

Detailed description: 
      Fraility index is calculated according to 70 parameters which are present in national
      surgical quality improvement programme (NSQIP) of American College of Surgeons. This model
      defines fraility as a cumulative effect of individual defects depending on clinical symptoms,
      disease states and disabilities which provides more accurate evaluation of aging. These 70
      parameters present in NSQIP database were matched with 11 variables to create a modified
      fraility index.

      There are 11 parametres in Modified Fraility Index (MFI) (Exacerbation of chronic obstructive
      pulmonary disease or history of pneumonia (within last 30 days), exacerbation of congestive
      heart failure (within last 30 days), diabetes mellitus, dependant functional status
      (partially or totally dependant), history of angina, percutaneous coronary intervention or
      coronary bypass grefting) (within last 30 days), medically treated hypertension, acute
      impaired sensorium, history of peripheral vascular disease, history of myocardial infarction
      (within last 6 months), cerebrovascular disease with neurological deficit, cerebrovascular
      disease without neurological deficit or transient ischemic attack (TIA).

      Presence of one of the above MFI parameters has taken 1 point. The total point that each
      individual achieved according to the presence of the parameters is calculated and the total
      score divided by 11 is defined as MFI value.

      145 patients aged between 45-85 who had undergone primary or revision total knee and hip
      arthroplasty were included to the current prospective study. In all patients MFI was
      calculated.

      Patients were classified as nonfrail (MFI<0,27), and frail patients (MFI≥0.27) according to
      MFI value.

      All patients were followed up for 30 days during postoperative period. The presence of
      myocardial infarction, cardiac arrest, pulmonary embolism, septic shock, postoperative
      dialysis requirement, cerebrovascular event, reintubation, reoperation, prolonged mechanical
      ventilation, surgical wound complications; duration of hospitalization; requirement for
      intensive care unit (ICU) admission and rehospitalization and 30th day mortality were
      questioned.
    

Observational model: Case-Control
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        patients aged between 45-85 undergoing primary or revision total knee and hip arthroplasty
      
Keywords: arthroplasty, fraility