Aug 2026· Spinal Cord· Vol 64, pp. 827 - 833· 0 citations· 22 references
Medicine
TL;DR
Frailty, assessed using the mFI-5, is an independent predictor of pneumonia and infections in older adults with CSCI and early assessment of frailty may facilitate perioperative risk stratification, targeted preventive strategies, and informed clinical decision-making in this high-risk population.
The 5-item Modified Frailty Index is a simple and clinically useful tool for identifying older head and neck cancer patients at increased risk of adverse outcomes following major surgery.
John J Sykes, Edgar D Uribe Sanchez, D. Benito et al.· Oral Oncology· 1 citation
BACKGROUND
Femoral neck fractures (FNFs) are common in the elderly and are typically treated operatively. Tools like frailty assessments may be critical for evaluating peri- and postoperative patient needs. Our study evaluated the utility of frailty, measured by the Risk Analysis Index (RAI) and the Modified 5-Item Frailty Index (mFI-5), in predicting 30-day mortality in patients undergoing hemiarthroplasty (HA) or total hip arthroplasty (THA) for FNFs.
METHODS
A national database was queried from 2015 to 2020 for patients 18 years of age or older undergoing HA or THA for FNFs. A total of 14,913 patients who had surgically managed FNFs were included. The primary outcome was 30-day mortality. Multivariate regressions were used to evaluate predictive value, and receiver operating characteristic curves assessed frailty accuracy.
RESULTS
Frailty as measured by the mFI-5 and RAI was predictive of increased odds of 30-day mortality in HA (RAI = odds ratio (OR): 1.46, 95% confidence interval (CI): 1.31 to 1.64; mFI-5 = OR: 1.10 (1.08 to 1.12, P < 0.001 for both)) and THA (RAI = OR: 1.15 (CI: 1.106 to 1.190, P < 0.001), mFI-5 = OR: 1.50 (CI: 1.167 to 1.923, P = 0.002)). The RAI demonstrated superior risk discrimination when compared to the mFI-5 for THA (RAI = C-statistic: 0.84, 95% CI: 0.45 to 0.83 versus mFI-5 = C-statistic: 0.69, 95% CI: 0.68 to 0.71) and HA (RAI = C-statistic: 0.74, 95% CI: 0.73 to 0.75 versus mFI-5 = C-statistic: 0.62, 95% CI: 0.61 to 0.63).
CONCLUSION
Frailty was found to be a predictor of mortality in patients who had FNFs undergoing THA and HA. Compared to the mFI-5, the RAI demonstrated superior predictive value for mortality across both operations. Thus, the RAI may be a powerful tool for assessing preoperative risk in patients undergoing arthroplasty for FNFs.
Ethan Parisier, Victor Koltenyuk, Nithin K. Gupta et al.· Journal of Arthroplasty· 0 citations
AIM
To determine whether frailty is associated with activities of daily living (ADL) and other clinical outcomes in hospitalized older adults.
METHODS
MEDLINE, Embase and CENTRAL were searched for English-language cohort studies published from 1 January 2001 to 23 October 2025. Eligible studies included hospitalized adults aged ≥ 65 years (or samples with ≥ 80% aged ≥ 65 years), used a defined frailty measure and compared frail with non-frail participants. Two reviewers independently selected studies, extracted data and assessed risk of bias using the Quality In Prognosis Studies tool. Random-effects meta-analyses generated standardized mean differences (SMDs) or risk ratios (RRs) with 95% confidence intervals (CIs).
RESULTS
Fifty-seven cohort studies were included. Frailty was associated with worse ADL status (SMD -1.04, 95% CI -1.89 to -0.20), higher mortality (RR 2.26, 95% CI 1.86-2.76), lower likelihood of discharge home (RR 0.79, 95% CI 0.73-0.86), and higher 30-day (RR 1.47, 95% CI 1.13-1.90) and 90-day readmission risks (RR 1.75, 95% CI 1.07-2.86). Pneumonia risk was not statistically significant. Heterogeneity was substantial to considerable for all pooled outcomes.
CONCLUSIONS
Frailty identifies hospitalized older adults at increased risk of functional dependence, mortality, non-home discharge, and readmission. Substantial heterogeneity and residual confounding warrant cautious interpretation and support standardized frailty and functional-outcome assessment.
T. Kamo, R. Asahi, Y. Inaba et al.· Geriatrics & Gerontology Int...· 0 citations
The prognostic value of the 5-factor modified frailty index (mFI-5) in patients with proximal femur fractures who were monitored in the postoperative intensive care unit (ICU) and to evaluate its relationship with clinical outcomes was demonstrated.
Berkay Küçük, Osman Yağız Atlı· Journal of Medicine and Pall...· 0 citations
Because this retrospective study was limited by sample size, comorbidity-driven mFI-5 scoring, non-standardized delirium screening, and potential residual confounding, mFI-5 should be interpreted as a convenient screening marker rather than a stand-alone predictor.
K. Yamagata, S. Fukuzawa, Shohei Takaoka et al.· Diagnostics· 0 citations
Abstract Hip fracture is a major cause of morbidity, mortality, and functional decline among older adults. Frailty has emerged as an important prognostic factor in this population, and the Clinical Frailty Scale (CFS) offers a rapid and practical method for assessing frailty. This systematic review assessed the prognostic value of the 9-point CFS in older adults with hip fracture. A systematic search of PubMed, Scopus, and Web of Science was conducted for studies published between 2016 and 2025. Eligible studies included adults aged ≥65 years with hip fracture whose frailty was assessed using the CFS. Outcomes included mortality, postoperative complications, delirium, length of hospital stay, readmissions, discharge destination, institutionalization, and functional recovery. Two reviewers independently screened studies, extracted data, and assessed methodological quality using the Newcastle-Ottawa Scale. Due to heterogeneity in frailty thresholds, outcome definitions, and follow up duration, findings were summarized narratively. Fifteen studies involving more than 18,000 older adults were included. Higher CFS scores were consistently associated with increased short and long term mortality, post-operative complications, delirium, prolonged hospital stay, higher readmission rates, and greater likelihood of institutional discharge. The 9-point Clinical Frailty Scale is a practical prognostic tool in older adults with hip fracture.
Spyridoula Goutsou, Elias S. Vasiliadis, A. Kaspiris et al.· Journal of Frailty, Sarcopen...· 0 citations
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