Frailty, A vital Index to Predict Postoperative Complications After Skull Base Surgery

Researchers calculated the mFI‐5 score for 17,912 patients undergoing skull base surgeries using the National Surgical Quality Improvement Program (NSQIP) database from 2005 to 2018. They used multivariate logistic regression analysis to evaluate the association of increasing frailty with complications in the 30‐day postoperative period, with a subanalysis by operative location.

Key findings of the study were:

• Among 17,912 patients they noted that 45.5% of patients had a frailty score of one or greater.

• Upon multivariable regression analysis, they found frailty to be an independent predictor of overall complications (odds ratio [OR]: 1.325), life‐threatening complications (OR: 1.428), and mortality (OR: 1.453). Higher frailty also correlated with increased length of stay.

• When procedures were stratified by operative location, they observed that frailty correlated significantly with overall complications for middle, posterior, and multiple‐fossae operations but not the anterior fossa.

The authors concluded, "Frailty demonstrates a significant and stepwise association with life‐threatening postoperative morbidity, mortality, and length of stay following skull base surgeries. mFI‐5 is an objective and easily calculable measure of preoperative risk, which may facilitate perioperative planning and counselling regarding outcomes prior to surgery."

For further information:

https://onlinelibrary.wiley.com/doi/10.1002/lary.29485