In his own work, he and his team have found, using data from the National Surgical Quality Improvement Program, that frailty is a predictor of morbidity and mortality in inpatient head and neck surgery (JAMA Otolaryngol Head Neck Surg. 2013;139:783-789).
Explore This IssueJuly 2014
Researchers used the modified Frailty Index (mFI)—an assessment of 11 parameters, including diabetes, heart failure, hypertension needing medication, and functional status—to determine patients’ degree of frailty.
As the score on the mFI grew from 0 of 11 to 5 of 11, mortality increased from 0.2% to 11.9% and life-threatening complications rose from 1.2% to 26.2%. For all complications, the rate of complications rose from 9.5% at an mFI score of 0 to 40.5% at an mFI score of 0.44. “That is a very large difference,” Dr. Stachler said.
Other research has shown that high frailty scores predict unfavorable discharge and placement in assisted-care facilities. “It’s our duty right now,” Dr. Stachler said, “for everybody out there to disseminate this information to all of our colleagues so we can establish best practices for our elderly patients.”