Using a Modified Frailty Index to Predict Mortality Risk after Tracheostomy. (23rd August 2013)

• Record Type: Journal Article
• Authors: Johnson, Matthew S.; Bailey, Travis; Schmid, Kendra; Johanning, Jason
• Is Part Of: Otolaryngology--head and neck surgery. Volume 149(2013)Supplement 2
• Page Start: P53
• Page End: P54
• Publication Date: 2013-08-23
• Subjects: Head -- Surgery -- Periodicals; Neck -- Surgery -- Periodicals; Otolaryngology -- Periodicals; 617.51
• DOI: 10.1177/0194599813495815a63
• Languages: English
• ISSNs: 0194-5998

Abstract

Abstract : Objectives: Evaluate the utility of a modified frailty index to predict post‐operative mortality in patients undergoing tracheostomy. Methods: A retrospective chart review was conducted including all patients who underwent tracheostomy between 2007 and 2012. A modified frailty index consisting of 11 items based on the Revised Minimum Data Set Mortality Rating Index was retrospectively applied using the patients' status immediately prior to tracheostomy. The resultant 6‐month predicted mortality was compared to the Veterans Health Administration Surgical Quality Improvement Program's (VASQIP) 30‐day predicted mortality as well as actual mortality. Results: A total of 100 patients underwent tracheostomy during the study period. No patients were excluded. Sixty‐nine patients died within the study period. The 1, 6, and 12‐month mortality rates after tracheostomy were 25%, 43%, and 59% respectively. The predicted 30‐day mortality risk was 9.1% for non‐survivors compared to 5.2% for survivors (p = 0.05). The predicted 6‐month mortality risk was 40.5% for non‐survivors compared to 25.4% for survivors (p = 0.0003). The VASQIP calculator and modified frailty index both differentiated mortality risks between patients who survived less than 6 months versus greater than 6 months (p = 0.004 and 0.001, respectively). However, neither the VASQIP or modified frailty index differentiated mortality risks for head and neck cancer patients who survived less than 6 months versus greater than 6 months (p = 0.46 and 0.13, respectively). Conclusions: The modified frailty index identifies non‐cancer patients at high risk of post‐operative mortality after tracheostomy but does not identify high‐risk patients with head and neck cancer.