| Description |
- INTRODUCTION
The 5-factor modified Frailty Index (mFI-5) is a concise and effective tool for predicting adverse events after orthopedic operations. However, no studies have assessed its utility in patients undergoing open reduction and internal fixation of olecranon fractures. Therefore, this study aimed to analyze the predictive capacity of the mFI-5 for 30-day postoperative adverse events following olecranon fixation.
METHODS
We retrospectively reviewed the American College of Surgeons—National Surgery Quality Improvement Program (ACS-NSQIP) database, including patients older than 50 who underwent open reduction and internal fixation of olecranon fractures. A 5-item mFI score was then calculated for each patient. Postoperative complications, readmission, reoperation, and adverse discharge rates were recorded. Univariate and multivariable statistical analysis was performed to identify associations.
RESULTS
We identified 4,191 patients (median age: 69; interquartile range: (60-78), with the majority being female (n = 3063, 73%). When comparing patients with an mFI score of zero, those with an mFI of 2 or greater were nearly 3.5 times more likely to experience a postoperative complication (p <0.001). Additionally, individuals with an mFI of 2 or greater faced almost a 3-fold increased likelihood of readmission, nearly a 3-fold higher risk of adverse discharge (p <0.001), and an increased rate of mortality (p<0.002). Notably, fragility did not show any association with an elevated risk of reoperation within 30 days post-operation after controlling for demographic data.
CONCLUSION
An increasing level of fragility is predictive of postoperative complications, readmission, and adverse discharge following open reduction and internal fixation of olecranon fractures. Our findings emphasize that assessing fragility is pivotal in significantly contributing to informing surgical decision-making, patient counseling, and ultimately improving care.
Level of evidence: III
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