Frailty Is a Predictor of Immediate Postoperative Complications Following Surgical Management of Knee Dislocations
Author Type(s)
Student
Document Type
Article
Publication Date
7-1-2024
DOI
10.1007/s00590-024-03941-7
Journal Title
European Journal of Orthopaedic Surgery & Traumatology
Keywords
Humans, Frailty, Male, Female, Postoperative Complications, Knee Dislocation, Middle Aged, Adult, Aged, Length of Stay, Risk Factors, Obesity, Age Factors, Retrospective Studies
Disciplines
Medicine and Health Sciences
Abstract
PURPOSE: To assess the utility of frailty in predicting outcomes following surgical intervention for KDs.
METHODS: The NIS database was queried for non-congenital knee dislocations from 2015 to 2019 that underwent ligament repair or surgical reduction. Patients were assigned frailty scores using the mFI-11, and outcomes were compared. Multivariate regression and ROC curve analysis were used to assess the independent association of obesity, frailty, VI, and age with adverse outcomes.
RESULTS: A total of 3797 patients who underwent surgical management were included. Frailty was associated with extended LOS (OR 1.353, 95% CI 1.212-1.510, p < 0.001), adverse discharge (OR 1.716, 95% CI 1.515-1.946, p < 0.001), and complications (OR 1.449, 95% CI 1.352-1.553, p < 0.001). Severely frailty was associated with extended LOS (OR 1.838, 95% CI 1.611-2.097, p < 0.001), adverse discharge (OR 2.756, 95% CI 2.394-3.171, p < 0.001), and complications (OR 1.603, 95% CI 1.453-1.768, p < 0.001). Additionally, VI was a risk factor for extended LOS (OR 7.647 (6.442-9.076) p < 0.001), complications (OR 2.065 (1.810-2.341) p < 0.001), and adverse discharge (OR 1.825 (1.606-2.075), p < 0.001). Obesity was a risk factor for extended LOS (OR 1.599 (1.470-1.739), p < 0.001) and complications (OR 1.235 (1.108-1.377), p < 0.001). AUC analysis showed that frailty was the most accurate predictor of all outcomes when compared to VI, obesity, and age.
CONCLUSIONS: Frailty is superior to age and obesity, and comparable to VI, at predicting adverse outcomes following surgical management of KDs. These findings suggest that frailty assessment might play a role in risk stratification and preoperative planning for KD patients that require surgical intervention.
Recommended Citation
Koltenyuk, V., Merckling, M., Li, M., Chanmin, Z., & Butler, J. (2024). Frailty Is a Predictor of Immediate Postoperative Complications Following Surgical Management of Knee Dislocations. European Journal of Orthopaedic Surgery & Traumatology, 34 (5), 2465-2471. https://doi.org/10.1007/s00590-024-03941-7
