Cardiothoracic & vascular anesthesia
Utility of Frailty Index in Predicting Adverse Outcomes in Patients With the Same American Society of Anesthesiologists Class in Video-assisted Thoracoscopic Surgery
Authors' conclusion
Among VATS patients with identical ASA classes 2 and 3, the MFI-5 further stratified risk for reintubation and ventilator dependence >48 hours postsurgery.
Study context
- Population
- Patients undergoing video-assisted thoracoscopic surgery (VATS), National Surgical Quality Improvement Program (NSQIP)
- Participants
- 69,145 patients
- Exposure
- Modified Frailty Index (MFI-5) vs American Society of Anesthesiologists (ASA) class as preoperative risk-stratification tool
- Outcome
- Unplanned reintubation and ventilator dependence >48 h
Methodological detailsNSQIP database 2008–2021
- NSQIP database 2008–2021
Main finding
As reported in the abstract
Odds ratio (CI)P value
MFI 3 vs MFI 0ASA class 3 patients
5.1(3.7–7)
P = 0.002- ASA class + MFI-5 vs ASA class alone
- adjusted R2 difference +1.5%; P < 0.001
- Unplanned reintubation
- 1,277 (1.8%)
- Ventilator dependence >48 h
- 1,155 (1.7%)
- ASA class stronger correlation than MFI-5 with ventilator dependence (VentDep) (adjusted R2 difference)
- +6.1%
- ASA class stronger correlation than MFI-5 with reintubation (adjusted R2 difference)
- +1.5%
Observational data: associations, not effects.
Further findings
ASA class 2 subgroup
- MFI-5 stratified risk less reliably than in ASA class 3; reintubation probability increased from MFI 0-1 and 1-2; VentDep increased from MFI 0-1 only
- P = 0.005
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Utility of Frailty Index in Predicting Adverse Outcomes in Patients With the Same American Society of Anesthesiologists Class in Video-assisted Thoracoscopic Surgery. J Cardiothorac Vasc Anesth. Published 22 October 2024. doi:10.
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