Impact of modified Frailty Index-11 (mFI-11) on postoperative complications in patients undergoing transsphenoidal resection of pituitary tumors: Analysis of 2006–2014 ACS-NSQIP database. (October 2021)

• Record Type: Journal Article
• Authors: Nguyen, Sarah; Kim, Robert B.; Cox, Parker; Gamboa, Nicholas T.; Karsy, Michael; Couldwell, William T.; Menacho, Sarah T.
• Is Part Of: Journal of clinical neuroscience. Volume 92(2021)
• Page Start: 22
• Page End: 26
• Publication Date: 2021-10
• Subjects: Modified Frailty Index-11 -- Pituitary tumor -- Postoperative complications -- Transsphenoidal; Brain -- Surgery -- Periodicals; Neurosciences -- Periodicals; Nervous system -- Surgery -- Periodicals; Brain -- surgery -- Periodicals; Neurosurgical Procedures -- Periodicals; Neurosciences -- Periodicals; Electronic journals; 616.8
• DOI: 10.1016/j.jocn.2021.07.046
• Languages: English
• ISSNs: 0967-5868

Abstract

Highlights: Frailty is a better predictor of physiologic reserve than age alone. Increased frailty is associated with an increase in complications after many surgeries. Frailty does not predict poorer postoperative outcomes following TSRPT. Abstract: Introduction: Frailty is a measure of physiologic reserve that is frequently cited as a predictor of postoperative complications. However, the effect of frailty on patients undergoing a relatively common procedure such as transsphenoidal resection of pituitary tumors (TSRPT) is unknown. Therefore, we sought to explore this relationship using a large, national database. Methods: The 2006–2014 American College of Surgeons National Surgical Quality Improvement Program database was retrospectively reviewed to identify all patients who underwent TSRPT. Frailty scores were assigned using the established 11-factor modified Frailty Index (mFI-11). Patients were divided into low-frailty and high-frailty groups, based on mFI comorbidities of ≤ 1 and ≥ 2, respectively. Univariable and multivariable analyses were performed to evaluate the impact of frailty on postoperative outcomes and mortality. Results: A total of 993 patients were included in the analysis. The low-frailty group consisted of 825 patients; the high-frailty group comprised 168 patients. In univariable analysis, there were no significant differences in medical (low-frailty 4.8%, high-frailty 8.3%; p = 0.069) and surgical (low-frailty 1.1%, high-frailty 1.2%; p = 1.000) complications; however, the high-frailty group had a higher rate of mortality (3%) when compared with the low-frailty group (0.6%; p = 0.016, OR 4.07, p = 0.044) and longer hospitalization (4.5 ± 7.4 vs. 5.8 ± 6.8 days; p = 0.023). In multivariable analysis, frailty was a predictor of mortality but not complications or reoperation. Conclusions: Our study shows that frailty, as measured by the mFI-11, does not predict postoperative complications in patients who undergo TSRPT, but greater frailty is correlated with higher mortality and increased hospital length of stay.