Role of mFI-5 in predicting geriatric outcomes in laparoscopic cholecystectomy

Alexandra Z. Agathis, Venu G. Bangla, Celia M. Divino

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Background: Frailty is the age-related decline contributing to adverse outcome vulnerability. This study assesses the modified 5-factor frailty index's (mFI-5) ability to predict geriatric cholecystectomy outcomes. Methods: Laparoscopic cholecystectomy patients ages ≥65 were identified from the American College of Surgeons’ National Surgical Quality Improvement Program database (2018–2020). MFI-5 variables include hypertension, congestive heart failure, chronic obstructive pulmonary disease, diabetes, and functional status. Groups were stratified according to the number of comorbidities: mFI ​= ​0, mFI ​= ​1, mFI≥2. Results: 32,481 cases included 27.6% mFI ​= ​0, 46.4% mFI ​= ​1, 26.0% mFI≥2. Highest frailty correlated with increased discharges to not home (OR 1.88, p ​< ​0.01). Non-independent functional status was associated with mortality (OR 7.32), prolonged length of stay (LOS) (5.69), pneumonia (4.90), sepsis (3.78), readmission (2.60) (p ​< ​0.01). AUCs were calculated for prolonged LOS (0.89), discharges to not home (0.85), mortality (0.83), pneumonia (0.76), sepsis (0.76). Conclusions: Healthcare teams can use mFI-5 to target at-risk cholecystectomy patients and proactively intervene to avoid complications.

Original languageEnglish
Pages (from-to)697-702
Number of pages6
JournalAmerican Journal of Surgery
Volume226
Issue number5
DOIs
StatePublished - Nov 2023

Keywords

  • Cholecystectomy
  • Frailty
  • Geriatric
  • NSQIP
  • mFI-5

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