Higher modified frailty index score is associated with 30-day postoperative complications following revision total shoulder arthroplasty

Bruce Tanner Seibold; Theodore Quan; Amy Y Zhao; Philip M Parel; Jacob D Mikula; Frederick Mun; Umasuthan Srikumaran; Zachary R Zimmer

doi:10.1177/17585732241229215

Higher modified frailty index score is associated with 30-day postoperative complications following revision total shoulder arthroplasty

Shoulder Elbow. 2024 Jan 31:17585732241229215. doi: 10.1177/17585732241229215. Online ahead of print.

Authors

Bruce Tanner Seibold¹, Theodore Quan¹, Amy Y Zhao¹, Philip M Parel¹, Jacob D Mikula², Frederick Mun², Umasuthan Srikumaran², Zachary R Zimmer¹

Affiliations

¹ Department of Orthopaedic Surgery, The George Washington University, Washington, DC, USA.
² Department of Orthopaedic Surgery, Johns Hopkins University, Baltimore, MD, USA.

Abstract

Background: Previous studies have shown that increased 5-item modified frailty index (mFI-5) scores are associated with poor surgical outcomes. This study seeks to determine whether the comorbidities comprising the mFI-5 were correlated with poor outcomes following revision total shoulder arthroplasty (TSA).

Methods: Utilizing the National Surgical Quality Improvement Program database, a mFI-5 score was calculated for all patients 50 years and older who underwent revision TSA between 2013 and 2019. Pearson's Chi-squared tests and multivariable regression analysis were used to evaluate the association of the mFI score with various postoperative complications.

Results: Patients with a mFI-5 score of 2+ had significantly increased risk of readmission (OR 2.58), bleeding requiring transfusion (OR 3.66), extended length of stay (OR 2.43), and discharge to a non-home destination (OR 3.22) compared to patients with a mFI-5 score of 0. Relative to patients with a score of 1, those with a mFI-5 score of 2+ had an increased risk of postoperative transfusion (OR 2.46), extended length of stay (OR 2.16), and discharge to a non-home location (OR 2.84).

Discussion: The mFI-5 is a valuable tool that can stratify patients based on risk for postoperative complications following revision TSA.

Keywords: complications; etiology; frailty; modified frailty index; revision total shoulder arthroplasty.