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Modified frailty index predicts postoperative morbidity in adhesive small bowel obstruction: analyzing the National Inpatient Sample 2015-2019. | LitMetric

Modified frailty index predicts postoperative morbidity in adhesive small bowel obstruction: analyzing the National Inpatient Sample 2015-2019.

J Gastrointest Surg

Division of General Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada; Division of General Surgery, Department of Surgery, St. Joseph's Healthcare, Hamilton, Ontario, Canada. Electronic address:

Published: March 2024

AI Article Synopsis

  • - The study aimed to evaluate how well the modified frailty index (mFI) predicts postoperative outcomes in patients undergoing surgery for adhesive small bowel obstruction (ASBO) using data from the National Inpatient Sample (NIS) from 2015 to 2019.
  • - It found that frail patients (mFI ≥ 0.27) experienced higher rates of in-hospital mortality, increased postoperative complications, longer hospital stays, and higher healthcare costs compared to robust patients (mFI < 0.27).
  • - The findings suggest that using the mFI can help healthcare providers and patients make better-informed decisions about treatment and recovery expectations after surgery for ASBO.

Article Abstract

Background: There are limited data identifying predictors of postoperative outcomes in adhesive small bowel obstruction (ASBO). This study used the National Inpatient Sample (NIS) to assess the efficacy of the modified frailty index (mFI) to predict postoperative morbidity among patients undergoing an operation for ASBO.

Methods: A retrospective analysis of the NIS between September 1, 2015, and December 31, 2019, was performed to identify adult patients who underwent nonelective operative intervention for ASBO. The mFI was used to stratify patients as either frail (mFI value ≥ 0.27) or robust (mFI value < 0.27). The primary outcomes were overall in-hospital postoperative morbidity and mortality. The secondary outcomes were system-specific morbidity, length of stay (LOS), total in-hospital healthcare cost, and discharge disposition. Univariable and multivariable regressions were used.

Results: Overall, 23251 robust patients and 6122 frail patients were included. Adjusted analyses demonstrated that frail patients had increased in-hospital mortality (adjusted odds ratio [aOR], 2.16; 95% CI, 1.80-2.60), postoperative morbidity (aOR, 1.63; 95% CI, 1.52-1.74), postoperative LOS (adjusted mean difference [aMD], 0.97 days; 95% CI, 0.73-1.21), and total in-hospital healthcare costs (aMD, $18,921; 95% CI, $14,608-$23,235) and were less likely to be discharged home (aOR, 0.59; 95% CI, 0.55-0.63). The findings were unchanged on subgroup analysis of patients undergoing open operation and those older than 65 years of age.

Conclusion: The mFI may predict postoperative outcomes for ASBO. Stratifying patients based on frailty may assist clinicians and patients in making informed decisions, setting realistic expectations, and proactively planning postoperative disposition.

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Source
http://dx.doi.org/10.1016/j.gassur.2023.12.007DOI Listing

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