A predictive tool incorporating frailty scores for perioperative risk assessment in patients with spinal metastasis: a national retrospective cohort study.

Frailty and an Inflammation-Nutrition Composite for Predicting Postoperative Outcomes in Older Patients Undergoing Endometrial Cancer Surgery

Combining frailty with an objective inflammation–nutrition risk composite modestly improved internal model performance for 30-day severe complications and 90-day readmission in older EC patients, and 1-year non-EC death analysis remains exploratory.

Benchmarking risk prediction tools in spine surgery: a national registry analysis of albumin, frailty, and surgical calculators.

Lower preoperative albumin and higher ACS SRC predictions were robust, independent predictors of increased risk for major complications, CD-IV events, and mortality, and Multivariable regression confirmed that ACS SRC remains among the comprehensive tools for risk stratification in spine surgery.

Modified 5-Item Frailty Index Is Associated with Postoperative Delirium but Not Survival in Patients Undergoing Surgery for Oral Squamous Cell Carcinoma

Background/Objectives: Frailty is increasingly recognized as a clinically relevant marker of reduced physiological reserve in surgical oncology. The modified 5-item frailty index (mFI-5) is simple and practical, but its clinical significance in oral squamous cell carcinoma (OSCC) remains incompletely defined. This study evaluated the association between mFI-5-defined frailty and postoperative complications, especially postoperative delirium, as well as survival outcomes in patients undergoing surgery for OSCC. Methods: We retrospectively analyzed 127 patients who underwent surgical resection for OSCC with postoperative high care unit (HCU) management between 2013 and 2021. Frailty was defined as an mFI-5 score of ≥2. Clinical characteristics, postoperative outcomes, HCU stay, length of hospital stay, overall survival (OS), and disease-free survival (DFS) were compared between frail and non-frail groups. Univariable logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for postoperative complications. An exploratory multivariable logistic regression analysis for postoperative delirium was performed using age ≥65 years and sex as covariates. Delirium was retrospectively assessed from clinical documentation considered consistent with DSM-5 criteria. Results: Twenty-one patients (16.5%) were classified as frail. Postoperative delirium occurred more frequently in frail patients than in non-frail patients (42.9% vs. 19.8%; p = 0.023). In a multivariable logistic regression model adjusted for age ≥65 years and sex, mFI-5-defined frailty was significantly associated with postoperative delirium (adjusted OR, 3.07; 95% CI, 1.08–8.60; p = 0.035). No significant association was observed for pneumonia, surgical site infection, or free-flap reoperation. Frailty was not significantly associated with HCU stay, length of hospital stay, OS, or DFS. Conclusions: mFI-5-defined frailty was associated with postoperative delirium but not with survival outcomes in this OSCC cohort. Because this retrospective study was limited by sample size, comorbidity-driven mFI-5 scoring, non-standardized delirium screening, and potential residual confounding, mFI-5 should be interpreted as a convenient screening marker rather than a stand-alone predictor. Comprehensive perioperative assessment incorporating frailty, nutrition, sarcopenia, cognition, tumor burden, and treatment-related factors may better identify patients at risk.

Machine learning-based prediction of perioperative complications in spine surgery: a large-scale model development and validation study.

Evaluating the impact of frailty in older adults on functional outcomes post-mechanical thrombectomy: a multicentre study incorporating traditional and machine learning methods.

Prognostic value of the 5-Item Modified Frailty Index in elderly patients undergoing free flap reconstruction for head and neck cancer.

OBJECTIVE Frailty is a recognized risk factor for poor surgical outcomes, particularly in the elderly. This study evaluates the predictive value of the 5-item Modified Frailty Index in patients aged 70 and older undergoing head and neck cancer resection with microvascular free flap reconstruction. STUDY DESIGN Retrospective cohort study. SETTING Tertiary academic medical center. METHODS Patients aged ≥ 70 years old who underwent oncologic resection and free flap reconstruction from 2014 to 2022 were included. Patients were stratified by 5-item Modified Frailty Index score into non-frail (0), mildly frail (1), and moderately to severely frail (≥2). Primary outcomes included 90-day mortality, 30-day complications, readmission, and return to the operating room. Multivariable logistic regression was used to control potential confounders. RESULTS A total of 211 patients were included. Patients with 5-item Modified Frailty Index scores ≥ 2 had significantly higher 90-day mortality compared to less frail patients (p = 0.031), and they were more frequently discharged to a facility rather than home. While not statistically significant, complication and readmission rates were higher in frail patients. Multivariable analysis showed that patients with 5-item Modified Frailty Index ≥ 2 had increased odds of experiencing complications (OR 2.44, 95 % CI 1.06-5.91)and mortality (OR 1.17, 95 % CI 0.36-4.59). CONCLUSION The 5-item Modified Frailty Index is a simple and clinically useful tool for identifying older head and neck cancer patients at increased risk of adverse outcomes following major surgery. Its incorporation into preoperative risk assessment may improve surgical decision-making and perioperative planning by better stratifying risk and guiding resource allocation.