Frailty as a Predictor of Outcomes After Fibula Free Flap for Head and Neck Reconstruction: A Multi-Institutional Analysis Using the mFI-5.

Authors

Jia Wei Tee, Dany Matar, Lorenzo Puppi, Thomas Schaschinger, Tobias Niederegger, Iman Ghanad, Leonard Knoedler, Samuel Knoedler, Dennis P Orgill, Henri Kreiker, Carsten Rendenbach, Max Heiland, Gabriel Hundeshagen, Adriana C Panayi

Published in

Microsurgery. Volume 46. Issue 7. Pages e70301.

Abstract

Chronological age inadequately reflects physiologic vulnerability in older adults undergoing complex reconstruction. Frailty, quantified by the 5-item Modified Frailty Index (mFI-5), may better stratify perioperative risk in fibula free flap (FFF) reconstruction for head and neck defects, but its impact remains underdefined.
A retrospective cohort study of 406 adults undergoing FFF reconstruction (ACS-NSQIP, 2009-2023) evaluated the association between mFI-5 and 30-day postoperative outcomes. Multivariable logistic regression identified independent predictors of medical and surgical complications.
Higher mFI-5 scores were associated with increased medical complications (14.1% mFI-5 = 0 vs. 34.3% mFI-5 = 2; p = 0.02), including pneumonia and myocardial infarction. mFI-5 = 1 (aOR 1.84; 95% CI, 1.01-3.47) and mFI-5 = 2 (aOR 3.45; 95% CI, 1.38-8.57) independently predicted medical complications; mFI-5 = 2 also predicted surgical complications (aOR 2.27; 95% CI, 1.00-5.43).
Frailty is a stronger predictor of postoperative morbidity than chronological age. Incorporating frailty assessment may enhance risk stratification and perioperative decision-making.

PMID:
42855949
Bibliographic data and abstract were imported from PubMed on 10 Oct 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.