Modified Frailty Index is an Effective Risk Assessment Tool in Primary Total Hip Arthroplasty

Abstract Background Frailty is described as decreased physiologic reserve and typically increases with age. Hospitals are being penalized for reoperations and readmissions, which can affect reimbursement. The purpose of this study was to determine if the modified frailty index (MFI) could be used as a risk assessment tool for preoperative counseling and to make an objective decision on whether or not to perform total hip arthroplasty (THA) on a frail patient. Methods The American College of Surgeons National Surgical Quality Improvement Program database was queried by Current Procedural Terminology code for primary THA (27130) from 2005-2014. MFI was calculated using 11 variables extracted from the medical record. Bivariate analysis was performed for outcomes and complications and multiple logistic regression model was used to compare MFI to other predictors of readmission, any complication, and reoperation. Results 51,582 patients underwent primary THA during the study period. MFI was a significant and stronger predictor than ASA and age for readmission (OR 14.72, 95% CI: 6.95-31.18, p