Work

Association of frailty with perioperative outcomes after mastectomy with and without immediate breast reconstruction

Year: 2025

Type: article

Abstract: Background: Frailty has been recognized as an independent risk factor for adverse postoperative outcomes. Coding based frailty instruments such as the Modified Frailty Index (mFI-5) are increasingly incorporated into risk models to provide better prediction of mortality, and complications. However, few have examined the large-scale utility of mFI-5 in the context of mastectomy and breast reconstruction. Methods: All elective adult (≥ 18 years) hospitalizations in women for mastectomy, with and without immediate breast reconstruction (IBR) were identified in the 2016-2022 National Inpatient Sample. Patients with an mFI-5 score ≥ 2 were considered Frail. Multivariable regression models were constructed to evaluate the association of frailty with major complications, length of stay (LOS) and inpatient costs. Results: < 0.001), was more commonly of Black race (23.7 vs 11.8 %, P < 0.001) and of the lowest income quartile (29.8 vs 17.1 %, P < 0.001).Following comprehensive risk adjustment, frailty was associated with increased odds of infectious (AOR 2.36, CI 1.35-4.13), respiratory (AOR 2.05, CI 1.44-2.92), and renal (AOR 5.62, CI 4.16-7.60) complications. Moreover, frailty was associated with greater length of stay, but no difference in hospitalization costs. Conclusions: Frailty remains associated with greater postoperative complications and length of stay. Status of frailty as ascertained by the mFI-5 may be useful in stratifying patient risk among those receiving mastectomy.

Source: Surgery Open Science

DOI: 10.1016/j.sopen.2025.08.004