COMPARISON OF THE MODIFIED 5-ITEM FRAILTY INDEX WITH THE AMERICAN SOCIETY OF ANESTHESIOLOGISTS CLASSIFICATION AND CHARLSON AGE COMORBIDITY INDEX FOR PREDICTING POSTOPERATIVE OUTCOMES IN GERIATRIC PATIENTS: A PROSPECTIVE OBSERVATIONAL STUDY

Introduction: Frailty scores estimate postoperative outcomes in elderly patients. This study sought to compare the performance of the modified 5 -item frailty index (mFI-5) with the other indexes as postoperative outcome predictors, especially for 1-year mortality in geriatric patients.Materials and Method: Patients aged >= 65 years who underwent elective surgery were enrolled. Along with comparisons in scoring systems, demographics, anesthesia method, operation duration, presence of preoperative transfusion, complications, length of hospitalization, intensive care admission, hospital mortality rate, and 1-year mortality were recorded. Pearson's chi-square test, receiver operating characteristic curve analysis, and binary logistic regression analysis were performed.Results: Overall, 33% of patients experienced complications and 12% were admitted to intensive care units. The hospital mortality rate was 3.3% (n=10), and the 1-year mortality rate was 27.4% (n=82). The Charlson aged comorbidity index was associated with the overall complications (Area Under Curve (AUC): 0.819, p<0.001) very well, and patients with a score over 5 have a 16.075 (p<0.001) times higher risk of hospital mortality. The American Society of Anesthesiologists (ASA) classification was associated satisfactorily with overall complications, intensive care admission, hospital mortality, and 1-year mortality (Respectively, AUC: 0.698, 0.662, 0.653, 0.629; p<0.05 in all). The mFI-5 score was associated well with intensive care admission (AUC: 0.702, p<0.001), and patients with a score over 2 have a 2.741 (p<0.02) times higher risk of 1-year mortality.Conclusions: The mFI-5 was associated with intensive unit admission and 1-year mortality and, was not superior to the ASA classification and the Charlson age comorbidity index classification in predicting the overall postoperative outcomes.