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Hernia

, Volume 23, Issue 5, pp 891–898 | Cite as

Ventral hernia repair outcomes predicted by a 5-item modified frailty index using NSQIP variables

  • F. M. BallaEmail author
  • C. G. Yheulon
  • J. L. Stetler
  • A. D. Patel
  • E. Lin
  • S. S. Davis
Original Article
Part of the following topical collections:
  1. Forum on primary midline uncomplicated ventral hernia

Abstract

Purpose

Frailty is a decrease in physiologic reserve that is separate from the normal aging process. Previously, an 11-item modified frailty index (mFI) using NSQIP variables predicted outcomes for surgical patients. We aim to validate a condensed 5-item mFI in ventral hernia patients and determine outcomes and the relative impact of each frailty variable.

Methods

The NSQIP database was queried from 2011 to 2016 for patients undergoing VHR. Spearman’s rho correlation was used to determine the degree of correlation between 11-item and 5-item mFI raw frailty scores. Chi squared testing was used to determine odds ratios (95% CI) for accumulating frailty variables in both indices with regard to complications vs a baseline of zero variables present on the 11-item scale. Complications were defined by the Clavien–Dindo (CD) classification. Univariate and multivariate analyses were performed on each frailty variable to determine their relative weighted impacts on outcomes.

Results

97,905 patients (99.45%) had all five frailty variables recorded. Only 11,549 patients (11.73%) had all variables from the 11-item mFI. No difference existed between groups for the five mutually shared frailty variables, BMI, emergent vs non-emergent procedures, operative time, or operative approach. For accumulating variables in both indices, the 5-item mFI predicts incidence of any complications, major complications, and discharge not to home similarly to the 11-item mFI. The most significantly weighted variable for complications and discharge not to home is functional status.

Conclusion

A 5-item mFI accurately predicts outcomes similar to the validated 11-item mFI and captures more patients for analysis.

Keywords

Frailty Ventral hernia NSQIP Modified frailty index Outcomes 

Notes

Compliance with ethical standards

Conflict of interest

The authors of this manuscript have no conflicts of interests or other disclosures.

Ethical approval

Approval from the institutional review board was not required for this study.

Human and animal rights

This article does not contain studies with human participants or animals performed by any of the authors given its retrospective nature.

Informed consent

Given the retrospective nature of this review, formal consent is not required.

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Copyright information

© Springer-Verlag France SAS, part of Springer Nature 2019

Authors and Affiliations

  • F. M. Balla
    • 1
    • 2
    Email author
  • C. G. Yheulon
    • 1
  • J. L. Stetler
    • 1
  • A. D. Patel
    • 1
  • E. Lin
    • 1
  • S. S. Davis
    • 1
  1. 1.Division of General and GI Surgery, Department of Surgery, School of MedicineEmory UniversityAtlantaUSA
  2. 2.PortlandUSA

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