Modified Frailty Index in prediction of complications after robot-assisted hepatectomy in elderly patients
DONG Shasha1, XIN Wenqi2
1. Department of Anesthesiology, the Sixth Medical Center of PLA General Hospital, Beijing 100048, China; 2. Department of Anesthesiology, Huaihe Hospital Affiliated to Henan University, Kaifeng 475004, China
Abstract：Objective To evaluate the value of modified frailty index (mFI) in the prediction of complications after robot-assisted hepatectomy in elderly patients. Methods The clinical data of 100 elderly patients undergoing robot-assisted hepatectomy at the Sixth Medical Center of PLA General Hospital from January 2021 to January 2024 were retrospectively analyzed, and the patients were divided into the frailty group (mFI≥0.27) and the non-frailty group (mFI < 0.27) according to the mFI value. The general perioperative data of the two groups were compared to explore the relationship between mFI score and postoperative complications and postoperative outcomes in elderly patients after robot-assisted hepatectomy. The accuracy of mFI score in predicting postoperative complications was evaluated by receiver operating characteristics (ROC) curve. Results A total of 90 elderly patients undergoing hepatectomy were included in this study, including 42 patients in the frailty group and 48 patients in the non-frailty group. There were statistical differences in age, ASA grade and total bilirubin between the two groups(P<0.05). The length of hospital stay and the incidence of complications within 30 days after operation in frailty group were higher than those in non-frailty group with statistically significant differences (P<0.05). Multivariate Logistic regression analysis showed that mFI was the independent risk factor for the complications in respiratory system (OR=5.691; 95%CI: 0.842~0.985; P=0.001), nervous system (OR=5.162; 95%CI: 0.836~0.968; P=0.001), and cardiovascular system (OR=7.548; 95%CI: 0.873~0.996; P=0.001). Conclusions mFI has clinical application value in predicting postoperative complications in elderly patients with robot-assisted hepatectomy.
Yoshino O,Wang Y, McCarron F, et al. Major hepatectomy in elderly patients: possible benefit from robotic platform utilization[J]. Surg Endosc,2023,37(8):6228-6234.
Hildebrand N,Verkoulen K,Dewulf M,et al. Short-term outcomes of laparoscopic versus open hepatectomy in the elderly patient:systematic review and meta-analysis[J].HPB(Oxford),2021,23(7):984-993.
[6]
Bludevich B M, Emmerick I, Uy K, et al. Association between the modified frailty index and outcomes following lobectomy[J]. J Surg Res,2023,283: 559-571.
[7]
Delvecchio A, Conticchio M, Ratti F, et al. Laparoscopic major hepatectomy for hepatocellular carcinoma in elderly patients: a multicentric propensity scorebased analysis[J]. Surg Endosc,2021,35(7):3642-3652.
Ogata T, Sadakari Y, Nakane H, et al. The five-item modified frailty index predicts long-term outcomes in elderly patients undergoing colorectal cancer surgery[J]. World J Surg Oncol,2023,21(1):268.
[12]
Maeda Y, Eto K, Yoshida N, et al. The 5-factor modified frailty index is a novel predictive marker of death from other diseases after curative gastrectomy for gastric cancer[J]. Geriatr Gerontol Int,2023,23(10):750-756.
Ali B, Choi E E, Barlas V, et al. Modified frailty index (mFI) predicts 30-day complications after microsurgical breast reconstruction[J]. J Plast Surg Hand Surg,2022,56(4):229-235.
[18]
Suzuki Y,Tei M,Ohtsuka M,et al. Effectiveness of frailty screening and perioperative team management of colectomy patients aged 80 years or more[J].Am J Surg,2022, 223(2):346-352.
Shen Y, Hao Q, Wang Y, et al. The association between preoperative modified frailty index and postoperative complications in Chinese elderly patients with hip fractures[J]. BMC Geriatr,2021,21(1): 370.
Taghlabi K M, Quaddoura A A, Nisar A, et al. Modified 5-item frailty index: a useful tool for assessing the impact of frailty on postoperative morbidity and mortality following surgical fixation of thoracolumbar fractures[J].World Neurosurgery,2024,187: e1062-e1071.
[24]
Li R,Sidawy A, Nguyen B N.The 5-Factor modified frailty index is a succinct yet effective predictor of adverse outcomes in patients undergoing open surgery for abdominal aortic aneurysm[J]. Ann Vasc Surg,2024,104: 139-146.
Edward C, Tjoson T, Yarah M, et al. Association between 5-item modified frailty index and short-term outcomes in complex head and neck surgery[J].Otolaryngol Head Neck Surg,2022,166(3): 482-489.
2025, Vol. 36 
