Application of mFI-5 in predicting early complications after TKA in the elderly
Objective Research on the application value of the Modified Frailty Index(mFI-5)for early postoperative com-plications of total knee arthroplasty(TKA)in elderly patients,providing reference for perioperative intervention of TKA patients and reducing the incidence of early postoperative complications.Methods Retrospective analysis of case data from 238 elderly TKA pa-tients aged 65 years or older in the Department of Orthopedics at Hebei University Affiliated Hospital from January 2021 to February 2023.According to the mFI-5 scale,patients with mFI-5≥2 were classified as the frailty group(n=70),while those with mFI-5＜2 were classified as the non frailty group(n=168).Basic data such as gender,BMI,smoking,drinking,surgical site and operation time were compared between the two groups,and the basic data with statistical significance and postoperative complications were analyzed by multi-variate logistic regression analysis and ROC curve was drawn.mFI-5 variables(previous history of COPD or chronic pneumonia,previous history of heart failure,history of hypertension requiring medication,type 2 diabetes,independent functional status),postoperative swell-ing,visual analogue scale(VAS),and American Knee Association score(AKS)were compared between the two groups.Univariate analy-sis and multivariate logistic regression analysis were performed for ear-ly postoperative complications,and ROC curves were drawn for early complications with statistically significant differences.Results Surgical time is an independent risk factor for postoperative infection and postoperative delirium(P＜0.05).The ROC curve showed that the area enclosed by the coordinate axis under the ROC curve for postoperative delirium(AUC)was 0.933,and the AUC for post-operative infection was 0.908(P＜0.05).The incidence,VAS score,and swelling degree score of the five variables of mFI-5 in the frail-ty group were higher than those in the non frailty group,while AKS score was lower than that in the non frailty group(P＜0.05).Multi-variate logistic regression analysis showed that frailty was an independent risk factor for deep vein thrombosis(DVT),postoperative in-fection,and postoperative delirium(P＜0.05).The ROC curve showed postoperative delirium AUC=0.670,postoperative infection AUC=0.758,and DVT AUC=0.746,with statistical significance(P＜0.05).Conclusion MFI-5 has clinical prediction and application val-ue for early postoperative complications in elderly TKA patients,which can provide reference for preoperative intervention and progno-sis evaluation of elderly TKA patients.Moreover,mFI-5 score≥2 is an effective indicator for predicting early postoperative complica-tions in TKA patients.
the modified 5-item frailty indextotal knee arthroplastycomplication
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