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...
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| Veröffentlicht in: | The Journal of arthroplasty 2017-10, Vol.32 (10), p.2963-2968 |
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| container_title | The Journal of arthroplasty |
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| creator | Bellamy, Jaime L., DO, MS Runner, Robert P., MD Vu, CatPhuong Cathy L., BA Schenker, Mara L., MD Bradbury, Thomas L., MD Roberson, James R., MD |
| description | 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 |
| doi_str_mv | 10.1016/j.arth.2017.04.056 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1904235537</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0883540317303972</els_id><sourcerecordid>1904235537</sourcerecordid><originalsourceid>FETCH-LOGICAL-c411t-b712bbcb172015ced1ce4871def27881e419727ade183bb89c81bff5f5cebb553</originalsourceid><addsrcrecordid>eNp9kcFq3DAQhkVpaLZpX6CHomMvdjWWtZahFJaQNIGUhDQ9FiHJI6qN195qvCH79pXZNIccehID3_zo_4axDyBKELD8vC5tmn6XlYCmFHUp1PIVW4CSVaFrsXzNFkJrWahayGP2lmgtBIBS9Rt2XGmlWmj1gv36PnYxROz4ebKxn_b8cujwkUfiduBnIaCf4gPy20j3fEWERBscJn43jj2PA79JcWPTPs-T7flF3PJV_lMat72laf-OHQXbE75_ek_Yz_Ozu9OL4ur62-Xp6qrwNcBUuAYq57yDJndRHjvwWOsGOgxVozVgDW1TNbZD0NI53XoNLgQVMuucUvKEfTrkbtP4Z4c0mU0kj31vBxx3ZKAVdSUz2GS0OqA-jUQJg9keKhgQZtZq1mbWamatRtQma81LH5_yd26D3fPKP48Z-HIAMLd8iJgM-YhDrhJTNmi6Mf4__-uLdd_HIXrb3-MeaT3u0pD9GTBUGWF-zIed7wqNFDKrkX8BHeueeA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1904235537</pqid></control><display><type>article</type><title>Modified Frailty Index is an Effective Risk Assessment Tool in Primary Total Hip Arthroplasty</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals Complete</source><creator>Bellamy, Jaime L., DO, MS ; Runner, Robert P., MD ; Vu, CatPhuong Cathy L., BA ; Schenker, Mara L., MD ; Bradbury, Thomas L., MD ; Roberson, James R., MD</creator><creatorcontrib>Bellamy, Jaime L., DO, MS ; Runner, Robert P., MD ; Vu, CatPhuong Cathy L., BA ; Schenker, Mara L., MD ; Bradbury, Thomas L., MD ; Roberson, James R., MD</creatorcontrib><description>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<0.001), any complication (OR 3.63, 95% CI: 1.64-8.05, p=0.002), and reoperation (OR 8.78, 95% CI: 3.67-20.98, p<0.001). As MFI increased, adverse discharge, any complication, readmission, reoperation, and mortality significantly increased (p<0.001). Rates of systemic complications and length of stay significantly increased with increasing MFI. Conclusion MFI is a simple and effective risk assessment tool to preoperatively counsel and make an objective decision on whether or not to perform THA on a frail patient.</description><identifier>ISSN: 0883-5403</identifier><identifier>EISSN: 1532-8406</identifier><identifier>DOI: 10.1016/j.arth.2017.04.056</identifier><identifier>PMID: 28559198</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Aged ; Arthroplasty, Replacement, Hip - adverse effects ; Arthroplasty, Replacement, Hip - mortality ; complication ; Databases, Factual ; Female ; Frailty ; Humans ; Logistic Models ; Male ; Middle Aged ; mortality ; Multivariate Analysis ; Odds Ratio ; Orthopedics ; Patient Discharge ; Patient Readmission - statistics & numerical data ; Postoperative Complications - epidemiology ; Postoperative Complications - etiology ; Preoperative Care ; Quality Improvement ; readmission ; reoperation ; Reoperation - statistics & numerical data ; Risk Assessment - methods ; total hip arthroplasty ; United States - epidemiology</subject><ispartof>The Journal of arthroplasty, 2017-10, Vol.32 (10), p.2963-2968</ispartof><rights>2017</rights><rights>Published by Elsevier Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c411t-b712bbcb172015ced1ce4871def27881e419727ade183bb89c81bff5f5cebb553</citedby><cites>FETCH-LOGICAL-c411t-b712bbcb172015ced1ce4871def27881e419727ade183bb89c81bff5f5cebb553</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0883540317303972$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65534</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28559198$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bellamy, Jaime L., DO, MS</creatorcontrib><creatorcontrib>Runner, Robert P., MD</creatorcontrib><creatorcontrib>Vu, CatPhuong Cathy L., BA</creatorcontrib><creatorcontrib>Schenker, Mara L., MD</creatorcontrib><creatorcontrib>Bradbury, Thomas L., MD</creatorcontrib><creatorcontrib>Roberson, James R., MD</creatorcontrib><title>Modified Frailty Index is an Effective Risk Assessment Tool in Primary Total Hip Arthroplasty</title><title>The Journal of arthroplasty</title><addtitle>J Arthroplasty</addtitle><description>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<0.001), any complication (OR 3.63, 95% CI: 1.64-8.05, p=0.002), and reoperation (OR 8.78, 95% CI: 3.67-20.98, p<0.001). As MFI increased, adverse discharge, any complication, readmission, reoperation, and mortality significantly increased (p<0.001). Rates of systemic complications and length of stay significantly increased with increasing MFI. Conclusion MFI is a simple and effective risk assessment tool to preoperatively counsel and make an objective decision on whether or not to perform THA on a frail patient.</description><subject>Aged</subject><subject>Arthroplasty, Replacement, Hip - adverse effects</subject><subject>Arthroplasty, Replacement, Hip - mortality</subject><subject>complication</subject><subject>Databases, Factual</subject><subject>Female</subject><subject>Frailty</subject><subject>Humans</subject><subject>Logistic Models</subject><subject>Male</subject><subject>Middle Aged</subject><subject>mortality</subject><subject>Multivariate Analysis</subject><subject>Odds Ratio</subject><subject>Orthopedics</subject><subject>Patient Discharge</subject><subject>Patient Readmission - statistics & numerical data</subject><subject>Postoperative Complications - epidemiology</subject><subject>Postoperative Complications - etiology</subject><subject>Preoperative Care</subject><subject>Quality Improvement</subject><subject>readmission</subject><subject>reoperation</subject><subject>Reoperation - statistics & numerical data</subject><subject>Risk Assessment - methods</subject><subject>total hip arthroplasty</subject><subject>United States - epidemiology</subject><issn>0883-5403</issn><issn>1532-8406</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kcFq3DAQhkVpaLZpX6CHomMvdjWWtZahFJaQNIGUhDQ9FiHJI6qN195qvCH79pXZNIccehID3_zo_4axDyBKELD8vC5tmn6XlYCmFHUp1PIVW4CSVaFrsXzNFkJrWahayGP2lmgtBIBS9Rt2XGmlWmj1gv36PnYxROz4ebKxn_b8cujwkUfiduBnIaCf4gPy20j3fEWERBscJn43jj2PA79JcWPTPs-T7flF3PJV_lMat72laf-OHQXbE75_ek_Yz_Ozu9OL4ur62-Xp6qrwNcBUuAYq57yDJndRHjvwWOsGOgxVozVgDW1TNbZD0NI53XoNLgQVMuucUvKEfTrkbtP4Z4c0mU0kj31vBxx3ZKAVdSUz2GS0OqA-jUQJg9keKhgQZtZq1mbWamatRtQma81LH5_yd26D3fPKP48Z-HIAMLd8iJgM-YhDrhJTNmi6Mf4__-uLdd_HIXrb3-MeaT3u0pD9GTBUGWF-zIed7wqNFDKrkX8BHeueeA</recordid><startdate>20171001</startdate><enddate>20171001</enddate><creator>Bellamy, Jaime L., DO, MS</creator><creator>Runner, Robert P., MD</creator><creator>Vu, CatPhuong Cathy L., BA</creator><creator>Schenker, Mara L., MD</creator><creator>Bradbury, Thomas L., MD</creator><creator>Roberson, James R., MD</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20171001</creationdate><title>Modified Frailty Index is an Effective Risk Assessment Tool in Primary Total Hip Arthroplasty</title><author>Bellamy, Jaime L., DO, MS ; Runner, Robert P., MD ; Vu, CatPhuong Cathy L., BA ; Schenker, Mara L., MD ; Bradbury, Thomas L., MD ; Roberson, James R., MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c411t-b712bbcb172015ced1ce4871def27881e419727ade183bb89c81bff5f5cebb553</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Aged</topic><topic>Arthroplasty, Replacement, Hip - adverse effects</topic><topic>Arthroplasty, Replacement, Hip - mortality</topic><topic>complication</topic><topic>Databases, Factual</topic><topic>Female</topic><topic>Frailty</topic><topic>Humans</topic><topic>Logistic Models</topic><topic>Male</topic><topic>Middle Aged</topic><topic>mortality</topic><topic>Multivariate Analysis</topic><topic>Odds Ratio</topic><topic>Orthopedics</topic><topic>Patient Discharge</topic><topic>Patient Readmission - statistics & numerical data</topic><topic>Postoperative Complications - epidemiology</topic><topic>Postoperative Complications - etiology</topic><topic>Preoperative Care</topic><topic>Quality Improvement</topic><topic>readmission</topic><topic>reoperation</topic><topic>Reoperation - statistics & numerical data</topic><topic>Risk Assessment - methods</topic><topic>total hip arthroplasty</topic><topic>United States - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bellamy, Jaime L., DO, MS</creatorcontrib><creatorcontrib>Runner, Robert P., MD</creatorcontrib><creatorcontrib>Vu, CatPhuong Cathy L., BA</creatorcontrib><creatorcontrib>Schenker, Mara L., MD</creatorcontrib><creatorcontrib>Bradbury, Thomas L., MD</creatorcontrib><creatorcontrib>Roberson, James R., MD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of arthroplasty</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bellamy, Jaime L., DO, MS</au><au>Runner, Robert P., MD</au><au>Vu, CatPhuong Cathy L., BA</au><au>Schenker, Mara L., MD</au><au>Bradbury, Thomas L., MD</au><au>Roberson, James R., MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Modified Frailty Index is an Effective Risk Assessment Tool in Primary Total Hip Arthroplasty</atitle><jtitle>The Journal of arthroplasty</jtitle><addtitle>J Arthroplasty</addtitle><date>2017-10-01</date><risdate>2017</risdate><volume>32</volume><issue>10</issue><spage>2963</spage><epage>2968</epage><pages>2963-2968</pages><issn>0883-5403</issn><eissn>1532-8406</eissn><abstract>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<0.001), any complication (OR 3.63, 95% CI: 1.64-8.05, p=0.002), and reoperation (OR 8.78, 95% CI: 3.67-20.98, p<0.001). As MFI increased, adverse discharge, any complication, readmission, reoperation, and mortality significantly increased (p<0.001). Rates of systemic complications and length of stay significantly increased with increasing MFI. Conclusion MFI is a simple and effective risk assessment tool to preoperatively counsel and make an objective decision on whether or not to perform THA on a frail patient.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>28559198</pmid><doi>10.1016/j.arth.2017.04.056</doi><tpages>6</tpages></addata></record> |
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| subjects | Aged Arthroplasty, Replacement, Hip - adverse effects Arthroplasty, Replacement, Hip - mortality complication Databases, Factual Female Frailty Humans Logistic Models Male Middle Aged mortality Multivariate Analysis Odds Ratio Orthopedics Patient Discharge Patient Readmission - statistics & numerical data Postoperative Complications - epidemiology Postoperative Complications - etiology Preoperative Care Quality Improvement readmission reoperation Reoperation - statistics & numerical data Risk Assessment - methods total hip arthroplasty United States - epidemiology |
| title | Modified Frailty Index is an Effective Risk Assessment Tool in Primary Total Hip Arthroplasty |
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