Back to 2025 Abstracts
Frailty As A Predictor Of Outcomes In Abdominal Wall Reconstruction
Michael I. Kim, BS, Idean Roohani, BS, Carly Askinas, MD, Joseph N. Carey, MD, David A. Daar, MD MBA, Emma C. Koesters, MD.
Keck School of Medicine of USC, Los Angeles, CA, USA.
Background: The modified frailty index-5 (mFI-5) - based on hypertension, diabetes, COPD, functional dependence, and congestive heart failure - assesses physiological reserve. While frailty has been shown to be a valuable predictor of poor outcomes across many surgical procedures, its predictive utility for outcomes after abdominal wall reconstruction (AWR) has not been delineated.
Methods: Patients from the 2005-2022 NSQIP database who underwent AWR were stratified by mFI-5 index (0-5). Primary outcomes included 30-day postoperative complications. Multivariable logistic regression and marginal effects were performed.
Results: Among 30,968 AWR patients, 650 had an mFI-5 index ≥3. Compared to those with scores of 0-2, this cohort demonstrated significantly higher rates of reoperation (9.0% vs. 4.9%), readmission (15.2% vs. 9.7%), surgical site infection (18.1% vs. 10.4%), venous thromboembolism (5.4% vs. 2.1%), and bleeding requiring transfusion (9.8% vs. 3.9%), all p < 0.001. Regression analysis showed mFI-5 ≥3 was linked to increased odds of all-cause complications (OR 3.39, p < 0.001), with marginal effects analysis revealing progressively higher risk with each increase in mFI-5 index (Figure 1).
Conclusion: Frailty is a strong predictor of adverse outcomes in AWR but is not routinely incorporated into preoperative assessment. Patients with mFI-5 index ≥3 face significantly higher risk of complications. These findings highlight the need for frailty assessment as part of comprehensive risk stratification in AWR.
Back to 2025 Abstracts
