NYMC Faculty Publications
Frailty as a Predictor of Postoperative Complications Following Skull Base Surgery
Author Type(s)
Faculty
DOI
10.1002/lary.29485
Journal Title
The Laryngoscope
First Page
1977
Last Page
1984
Document Type
Article
Publication Date
9-1-2021
Department
Neurosurgery
Abstract
OBJECTIVE/HYPOTHESIS: Frailty has emerged as a powerful risk stratification tool across surgical specialties; however, an analysis of the impact of frailty on outcomes following skull base surgery has not been published. The aim of this study was to assess the validity of the 5-factor modified frailty index (mFI-5) as a predictor of perioperative morbidity and mortality in patients undergoing skull base surgery.
METHODS: A mFI-5 score was calculated for patients undergoing skull base surgeries using the National Surgical Quality Improvement Program (NSQIP) database from 2005 to 2018. Multivariate logistic regression analysis was used to evaluate the association of increasing frailty with complications in the 30-day postoperative period, with a subanalysis by operative location.
RESULTS: A total of 17,912 patients who underwent skull base procedures were identified, with 45.5% of patients having a frailty score of one or greater; 44.9% were male and the mean age was 52.0 (±16.1 SD) years. Multivariable regression analysis revealed frailty to be an independent predictor of overall complications (odds ratio [OR]: 1.325, P < .001), life-threatening complications (OR: 1.428, P < .001), and mortality (OR: 1.453, P < .001). Higher frailty also correlated with increased length of stay. When procedures were stratified by operative location, frailty correlated significantly with overall complications for middle, posterior, and multiple-fossae operations but not the anterior fossa.
CONCLUSIONS: Frailty demonstrates a significant and stepwise association with life-threatening postoperative morbidity, mortality, and length of stay following skull base surgeries. mFI-5 is an objective and easily calculable measure of preoperative risk, which may facilitate perioperative planning and counseling regarding outcomes prior to surgery.
LEVEL OF EVIDENCE: 3 Laryngoscope, 131:1977-1984, 2021.
Recommended Citation
Henry, R. K., Reeves, R. A., Wackym, P. A., Ahmed, O. H., Hanft, S. J., & Kwong, K. M. (2021). Frailty as a Predictor of Postoperative Complications Following Skull Base Surgery. The Laryngoscope, 131 (9), 1977-1984. https://doi.org/10.1002/lary.29485
