2Gazi University, Faculty of Medicine, Department of Radiology, Ankara, Türkiye DOI : 10.29400/tjgeri.2025.465 Introduction: This study aims to assess the predictive efficacy of the modified Frailty Index for 30-day postoperative outcomes in elderly patients undergoing vascular surgery and to evaluate its additional value compared with conventional tools.
Materials and Method: This retrospective cohort study examined 155 consecutive patients aged ? 65 years who underwent elective vascular surgery. The preoperative 11-item modified Frailty Index was calculated using National Surgical Quality Improvement Program variables. The primary endpoint was 30-day mortality, and secondary endpoints included surgical site infection, myocardial infarction, septic shock, reintubation, stroke, and acute kidney injury.
Results: The mean age was 71.98 ± 5.59 years. The 30-day mortality rate was 16.8%. The modified Frailty Index was higher in non-survivors than in survivors (3.96±1.48 vs 1.96±1.11, p<0.001) and showed excellent mortality prediction (Area Under the Curve=0.851, 95% CI: 0.778-0.924), with a threshold of 2.5 (sensitivity 84.6%, specificity 73.6%). In the multivariate analysis, adjusting for age, sex, American Society of Anesthesiologists score, and Geriatric Nutritional Risk Index, the modified Frailty Index remained associated with mortality (adjusted OR=2.79, 95% CI, 1.52-5.13; p=0.001). Each point increase correlated with higher risk of surgical site infection (OR=1.55, 95% CI: 1.19-2.03, p=0.001), myocardial infarction (OR=2.46, 95% CI: 1.27-4.78, p=0.008), septic shock (OR =2.46, 95% CI: 1.27-4.78, p=0.008), reintubation (OR=2.70, 95% CI: 1.82-4.02, p<0.001), and renal failure (OR=2.05, 95% CI: 1.43-2.94, p< 0.001).
Conclusions: The 11-item modified Frailty Index predicted adverse outcomes in geriatric vascular surgery patients. Its use in risk stratification may improve perioperative management.
Keywords : Frailty; Vascular Surgical Procedures; Geriatrics; Risk Assessment; Mortality