Background: Identifying at-risk patients for complications remains challenging in patients with chronic lower extremity (LE) wounds receiving free tissue transfer (FTT) for limb salvage. The modified-5 frailty index (mFI-5) has been utilized to predict postoperative complications, yet it has not been studied in this population. The aim of this study was to determine the utility of the mFI-5 in predicting adverse postoperative outcomes.Methods: Patients >= 60 years, who underwent LE FTT reconstruction at a single institution from 2011 to 2022, were retrospectively reviewed. Patient characteristics, mFI-5, and postoperative outcomes were collected. Cohorts were divided by an mFI-5 score of <2 or >= 2.Results: A total of 115 patients were identified, of which 71.3% (n = 82) were male, 64.3% (n = 74) had a mFI-5 score of >= 2, and 35.7% (n = 41) had a score <2. The average age and body mass index were 67.8 years and 28.7 kg/m(2) , respectively. The higher mFI-5 cohort had lower baseline albumin levels (3.0 vs. 4.0 g/dL, p = .015) and higher hemoglobin A1c levels (7.4 vs. 5.8%, p < .001). The postoperative length of stay was longer in the higher mFI-5 cohort (18 vs. 13.4 days, p = .003). The overall flap success was 96.5% (n = 111), with no difference between cohorts (p = .129). Postoperative complications were comparable between cohorts (p = .294). At a mean follow-up of 19.8 months, eight patients (7.0%) underwent amputation, and 91.3% (n = 105) were ambulatory.Conclusion: High microsurgical success rates can be achieved in comorbid patients with high frailty indexes who undergo FTT for limb salvage. A multidisciplinary team approach may effectively mitigate negative outcomes in elderly, frail patients.
机构:
Massachusetts Eye & Ear Infirm, Dept Otolaryngol Head & Neck Surg, Div Facial Plast & Reconstruct Surg, Boston, MA 02114 USA
Harvard Univ, Sch Publ Hlth, Boston, MA 02115 USAMassachusetts Eye & Ear Infirm, Dept Otolaryngol Head & Neck Surg, Div Facial Plast & Reconstruct Surg, Boston, MA 02114 USA
Bhama, Prabhat K.
Patel, Sapna A.
论文数: 0引用数: 0
h-index: 0
机构:
Univ Washington, Med Ctr, Dept Otolaryngol Head & Neck Surg, Seattle, WA 98195 USAMassachusetts Eye & Ear Infirm, Dept Otolaryngol Head & Neck Surg, Div Facial Plast & Reconstruct Surg, Boston, MA 02114 USA
Patel, Sapna A.
Khan, Umer
论文数: 0引用数: 0
h-index: 0
机构:
Seattle Childrens Res Inst, Seattle, WA USAMassachusetts Eye & Ear Infirm, Dept Otolaryngol Head & Neck Surg, Div Facial Plast & Reconstruct Surg, Boston, MA 02114 USA
Khan, Umer
Bhrany, Amit D.
论文数: 0引用数: 0
h-index: 0
机构:
Univ Washington, Med Ctr, Dept Otolaryngol Head & Neck Surg, Seattle, WA 98195 USAMassachusetts Eye & Ear Infirm, Dept Otolaryngol Head & Neck Surg, Div Facial Plast & Reconstruct Surg, Boston, MA 02114 USA
Bhrany, Amit D.
Futran, Neal D.
论文数: 0引用数: 0
h-index: 0
机构:
Univ Washington, Med Ctr, Dept Otolaryngol Head & Neck Surg, Seattle, WA 98195 USAMassachusetts Eye & Ear Infirm, Dept Otolaryngol Head & Neck Surg, Div Facial Plast & Reconstruct Surg, Boston, MA 02114 USA
机构:
Med Coll Wisconsin, Div Gen Surg, Dept Surg, 9200 West Wisconsin Ave, Milwaukee, WI 53226 USAMed Coll Wisconsin, Div Gen Surg, Dept Surg, 9200 West Wisconsin Ave, Milwaukee, WI 53226 USA
Chimukangara, Munyaradzi
Helm, Melissa C.
论文数: 0引用数: 0
h-index: 0
机构:
Med Coll Wisconsin, Div Gen Surg, Dept Surg, 9200 West Wisconsin Ave, Milwaukee, WI 53226 USAMed Coll Wisconsin, Div Gen Surg, Dept Surg, 9200 West Wisconsin Ave, Milwaukee, WI 53226 USA
Helm, Melissa C.
Frelich, Matthew J.
论文数: 0引用数: 0
h-index: 0
机构:
Med Coll Wisconsin, Div Gen Surg, Dept Surg, 9200 West Wisconsin Ave, Milwaukee, WI 53226 USAMed Coll Wisconsin, Div Gen Surg, Dept Surg, 9200 West Wisconsin Ave, Milwaukee, WI 53226 USA
Frelich, Matthew J.
Bosler, Matthew E.
论文数: 0引用数: 0
h-index: 0
机构:
Med Coll Wisconsin, Div Gen Surg, Dept Surg, 9200 West Wisconsin Ave, Milwaukee, WI 53226 USAMed Coll Wisconsin, Div Gen Surg, Dept Surg, 9200 West Wisconsin Ave, Milwaukee, WI 53226 USA
Bosler, Matthew E.
Rein, Lisa E.
论文数: 0引用数: 0
h-index: 0
机构:
Med Coll Wisconsin, Dept Biostat, Milwaukee, WI 53226 USAMed Coll Wisconsin, Div Gen Surg, Dept Surg, 9200 West Wisconsin Ave, Milwaukee, WI 53226 USA
Rein, Lisa E.
Szabo, Aniko
论文数: 0引用数: 0
h-index: 0
机构:
Med Coll Wisconsin, Dept Biostat, Milwaukee, WI 53226 USAMed Coll Wisconsin, Div Gen Surg, Dept Surg, 9200 West Wisconsin Ave, Milwaukee, WI 53226 USA
Szabo, Aniko
Gould, Jon C.
论文数: 0引用数: 0
h-index: 0
机构:
Med Coll Wisconsin, Div Gen Surg, Dept Surg, 9200 West Wisconsin Ave, Milwaukee, WI 53226 USAMed Coll Wisconsin, Div Gen Surg, Dept Surg, 9200 West Wisconsin Ave, Milwaukee, WI 53226 USA
Gould, Jon C.
[J].
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES,
2017,
31
(06):
: 2509
-
2519
机构:
Staten Isl Univ Hosp, Div Plast Reconstruct & Hand Surg, Staten Isl, NY 10305 USAStaten Isl Univ Hosp, Div Plast Reconstruct & Hand Surg, Staten Isl, NY 10305 USA
Culliford, Alfred T.
Spector, Jason
论文数: 0引用数: 0
h-index: 0
机构:Staten Isl Univ Hosp, Div Plast Reconstruct & Hand Surg, Staten Isl, NY 10305 USA
Spector, Jason
Blank, Alan
论文数: 0引用数: 0
h-index: 0
机构:Staten Isl Univ Hosp, Div Plast Reconstruct & Hand Surg, Staten Isl, NY 10305 USA
Blank, Alan
Karp, Nolan S.
论文数: 0引用数: 0
h-index: 0
机构:Staten Isl Univ Hosp, Div Plast Reconstruct & Hand Surg, Staten Isl, NY 10305 USA
Karp, Nolan S.
Kasabian, Armen
论文数: 0引用数: 0
h-index: 0
机构:Staten Isl Univ Hosp, Div Plast Reconstruct & Hand Surg, Staten Isl, NY 10305 USA
Kasabian, Armen
Levine, Jamie P.
论文数: 0引用数: 0
h-index: 0
机构:Staten Isl Univ Hosp, Div Plast Reconstruct & Hand Surg, Staten Isl, NY 10305 USA
机构:
Massachusetts Eye & Ear Infirm, Dept Otolaryngol Head & Neck Surg, Div Facial Plast & Reconstruct Surg, Boston, MA 02114 USA
Harvard Univ, Sch Publ Hlth, Boston, MA 02115 USAMassachusetts Eye & Ear Infirm, Dept Otolaryngol Head & Neck Surg, Div Facial Plast & Reconstruct Surg, Boston, MA 02114 USA
Bhama, Prabhat K.
Patel, Sapna A.
论文数: 0引用数: 0
h-index: 0
机构:
Univ Washington, Med Ctr, Dept Otolaryngol Head & Neck Surg, Seattle, WA 98195 USAMassachusetts Eye & Ear Infirm, Dept Otolaryngol Head & Neck Surg, Div Facial Plast & Reconstruct Surg, Boston, MA 02114 USA
Patel, Sapna A.
Khan, Umer
论文数: 0引用数: 0
h-index: 0
机构:
Seattle Childrens Res Inst, Seattle, WA USAMassachusetts Eye & Ear Infirm, Dept Otolaryngol Head & Neck Surg, Div Facial Plast & Reconstruct Surg, Boston, MA 02114 USA
Khan, Umer
Bhrany, Amit D.
论文数: 0引用数: 0
h-index: 0
机构:
Univ Washington, Med Ctr, Dept Otolaryngol Head & Neck Surg, Seattle, WA 98195 USAMassachusetts Eye & Ear Infirm, Dept Otolaryngol Head & Neck Surg, Div Facial Plast & Reconstruct Surg, Boston, MA 02114 USA
Bhrany, Amit D.
Futran, Neal D.
论文数: 0引用数: 0
h-index: 0
机构:
Univ Washington, Med Ctr, Dept Otolaryngol Head & Neck Surg, Seattle, WA 98195 USAMassachusetts Eye & Ear Infirm, Dept Otolaryngol Head & Neck Surg, Div Facial Plast & Reconstruct Surg, Boston, MA 02114 USA
机构:
Med Coll Wisconsin, Div Gen Surg, Dept Surg, 9200 West Wisconsin Ave, Milwaukee, WI 53226 USAMed Coll Wisconsin, Div Gen Surg, Dept Surg, 9200 West Wisconsin Ave, Milwaukee, WI 53226 USA
Chimukangara, Munyaradzi
Helm, Melissa C.
论文数: 0引用数: 0
h-index: 0
机构:
Med Coll Wisconsin, Div Gen Surg, Dept Surg, 9200 West Wisconsin Ave, Milwaukee, WI 53226 USAMed Coll Wisconsin, Div Gen Surg, Dept Surg, 9200 West Wisconsin Ave, Milwaukee, WI 53226 USA
Helm, Melissa C.
Frelich, Matthew J.
论文数: 0引用数: 0
h-index: 0
机构:
Med Coll Wisconsin, Div Gen Surg, Dept Surg, 9200 West Wisconsin Ave, Milwaukee, WI 53226 USAMed Coll Wisconsin, Div Gen Surg, Dept Surg, 9200 West Wisconsin Ave, Milwaukee, WI 53226 USA
Frelich, Matthew J.
Bosler, Matthew E.
论文数: 0引用数: 0
h-index: 0
机构:
Med Coll Wisconsin, Div Gen Surg, Dept Surg, 9200 West Wisconsin Ave, Milwaukee, WI 53226 USAMed Coll Wisconsin, Div Gen Surg, Dept Surg, 9200 West Wisconsin Ave, Milwaukee, WI 53226 USA
Bosler, Matthew E.
Rein, Lisa E.
论文数: 0引用数: 0
h-index: 0
机构:
Med Coll Wisconsin, Dept Biostat, Milwaukee, WI 53226 USAMed Coll Wisconsin, Div Gen Surg, Dept Surg, 9200 West Wisconsin Ave, Milwaukee, WI 53226 USA
Rein, Lisa E.
Szabo, Aniko
论文数: 0引用数: 0
h-index: 0
机构:
Med Coll Wisconsin, Dept Biostat, Milwaukee, WI 53226 USAMed Coll Wisconsin, Div Gen Surg, Dept Surg, 9200 West Wisconsin Ave, Milwaukee, WI 53226 USA
Szabo, Aniko
Gould, Jon C.
论文数: 0引用数: 0
h-index: 0
机构:
Med Coll Wisconsin, Div Gen Surg, Dept Surg, 9200 West Wisconsin Ave, Milwaukee, WI 53226 USAMed Coll Wisconsin, Div Gen Surg, Dept Surg, 9200 West Wisconsin Ave, Milwaukee, WI 53226 USA
Gould, Jon C.
[J].
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES,
2017,
31
(06):
: 2509
-
2519
机构:
Staten Isl Univ Hosp, Div Plast Reconstruct & Hand Surg, Staten Isl, NY 10305 USAStaten Isl Univ Hosp, Div Plast Reconstruct & Hand Surg, Staten Isl, NY 10305 USA
Culliford, Alfred T.
Spector, Jason
论文数: 0引用数: 0
h-index: 0
机构:Staten Isl Univ Hosp, Div Plast Reconstruct & Hand Surg, Staten Isl, NY 10305 USA
Spector, Jason
Blank, Alan
论文数: 0引用数: 0
h-index: 0
机构:Staten Isl Univ Hosp, Div Plast Reconstruct & Hand Surg, Staten Isl, NY 10305 USA
Blank, Alan
Karp, Nolan S.
论文数: 0引用数: 0
h-index: 0
机构:Staten Isl Univ Hosp, Div Plast Reconstruct & Hand Surg, Staten Isl, NY 10305 USA
Karp, Nolan S.
Kasabian, Armen
论文数: 0引用数: 0
h-index: 0
机构:Staten Isl Univ Hosp, Div Plast Reconstruct & Hand Surg, Staten Isl, NY 10305 USA
Kasabian, Armen
Levine, Jamie P.
论文数: 0引用数: 0
h-index: 0
机构:Staten Isl Univ Hosp, Div Plast Reconstruct & Hand Surg, Staten Isl, NY 10305 USA