The modified 5-item frailty index in total hip arthroplasty patients: a retrospective cohort from a low-middle income country
Abstract Background Total hip arthroplasty (THA) is increasing in low- and middle-income countries (LMICs) due to rising rates of hip fractures and an aging population. Identifying frail patients at risk for postoperative complications is vital for improving outcomes. This study examines the utility...
Saved in:
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2025-03-01
|
| Series: | Journal of Orthopaedic Surgery and Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13018-025-05505-9 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850143507299172352 |
|---|---|
| author | Usman Ali Shahzil Abdur Rehman Malik Bilal Iqbal Aribah Bhatti Sher Baz Khan Shahryar Noordin Anum Ali |
| author_facet | Usman Ali Shahzil Abdur Rehman Malik Bilal Iqbal Aribah Bhatti Sher Baz Khan Shahryar Noordin Anum Ali |
| author_sort | Usman Ali |
| collection | DOAJ |
| description | Abstract Background Total hip arthroplasty (THA) is increasing in low- and middle-income countries (LMICs) due to rising rates of hip fractures and an aging population. Identifying frail patients at risk for postoperative complications is vital for improving outcomes. This study examines the utility of the Modified 5-Item Frailty Index (mFI-5) in predicting 30-day morbidity and mortality in THA patients in resource-limited settings, where other models like the Elixhauser Comorbidity Measure (ECM) and Charlson Comorbidity Index (CCI) may be impractical due to data constraints. Methods This retrospective cohort study included 498 patients undergoing THA at tertiary-care hospital between January 2014 and December 2019. Patients were stratified based on their mFI-5 scores (≤ 1 vs. > 1). Postoperative complications, length of stay, and mortality were compared between groups. Multivariable logistic regression was used to assess outcomes. Results Of the 498 patients, 62.8% had an mFI-5 score ≤ 1, and 37.2% had a score > 1. Complication rates were higher in the mFI-5 > 1 group (17.8%) versus the ≤ 1 group (9.6%). After adjusting for covariates, patients with mFI-5 > 1 had a 97% higher likelihood of complications (aOR = 1.97, 95% CI 1.06–3.70). Each additional hospital day increased complication risk by 13% (aOR = 1.13, 95% CI: 1.05–1.21). Conclusion The mFI-5 is a practical, efficient tool for predicting postoperative complications in THA patients, particularly in resource-limited environments. Its use in LMICs could improve preoperative planning, reduce complications, and provide better outcome estimates for patients and healthcare providers. Given the growing geriatric population, integrating the mFI-5 into routine THA planning could enhance patient care and resource allocation. Further research is needed to validate its use across larger datasets. |
| format | Article |
| id | doaj-art-3d9c22854faf4ff2ab3a2c1b4b242714 |
| institution | OA Journals |
| issn | 1749-799X |
| language | English |
| publishDate | 2025-03-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj-art-3d9c22854faf4ff2ab3a2c1b4b2427142025-08-20T02:28:41ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2025-03-012011910.1186/s13018-025-05505-9The modified 5-item frailty index in total hip arthroplasty patients: a retrospective cohort from a low-middle income countryUsman Ali0Shahzil Abdur Rehman Malik1Bilal Iqbal2Aribah Bhatti3Sher Baz Khan4Shahryar Noordin5Anum Ali6Section of Orthopedic Surgery, Department of Surgery, The Aga Khan UniversitySection of Orthopedic Surgery, Department of Surgery, The Aga Khan UniversitySection of Orthopedic Surgery, Department of Surgery, The Aga Khan UniversityDow University of Health SciencesSection of Orthopedic Surgery, Department of Surgery, The Aga Khan UniversitySection of Orthopedic Surgery, Department of Surgery, The Aga Khan UniversitySection of Orthopedic Surgery, Department of Surgery, The Aga Khan UniversityAbstract Background Total hip arthroplasty (THA) is increasing in low- and middle-income countries (LMICs) due to rising rates of hip fractures and an aging population. Identifying frail patients at risk for postoperative complications is vital for improving outcomes. This study examines the utility of the Modified 5-Item Frailty Index (mFI-5) in predicting 30-day morbidity and mortality in THA patients in resource-limited settings, where other models like the Elixhauser Comorbidity Measure (ECM) and Charlson Comorbidity Index (CCI) may be impractical due to data constraints. Methods This retrospective cohort study included 498 patients undergoing THA at tertiary-care hospital between January 2014 and December 2019. Patients were stratified based on their mFI-5 scores (≤ 1 vs. > 1). Postoperative complications, length of stay, and mortality were compared between groups. Multivariable logistic regression was used to assess outcomes. Results Of the 498 patients, 62.8% had an mFI-5 score ≤ 1, and 37.2% had a score > 1. Complication rates were higher in the mFI-5 > 1 group (17.8%) versus the ≤ 1 group (9.6%). After adjusting for covariates, patients with mFI-5 > 1 had a 97% higher likelihood of complications (aOR = 1.97, 95% CI 1.06–3.70). Each additional hospital day increased complication risk by 13% (aOR = 1.13, 95% CI: 1.05–1.21). Conclusion The mFI-5 is a practical, efficient tool for predicting postoperative complications in THA patients, particularly in resource-limited environments. Its use in LMICs could improve preoperative planning, reduce complications, and provide better outcome estimates for patients and healthcare providers. Given the growing geriatric population, integrating the mFI-5 into routine THA planning could enhance patient care and resource allocation. Further research is needed to validate its use across larger datasets.https://doi.org/10.1186/s13018-025-05505-9Total hip arthroplastymFI-5Frailty indexPostoperative complicationsLow- and middle-income countriesGeriatrics |
| spellingShingle | Usman Ali Shahzil Abdur Rehman Malik Bilal Iqbal Aribah Bhatti Sher Baz Khan Shahryar Noordin Anum Ali The modified 5-item frailty index in total hip arthroplasty patients: a retrospective cohort from a low-middle income country Journal of Orthopaedic Surgery and Research Total hip arthroplasty mFI-5 Frailty index Postoperative complications Low- and middle-income countries Geriatrics |
| title | The modified 5-item frailty index in total hip arthroplasty patients: a retrospective cohort from a low-middle income country |
| title_full | The modified 5-item frailty index in total hip arthroplasty patients: a retrospective cohort from a low-middle income country |
| title_fullStr | The modified 5-item frailty index in total hip arthroplasty patients: a retrospective cohort from a low-middle income country |
| title_full_unstemmed | The modified 5-item frailty index in total hip arthroplasty patients: a retrospective cohort from a low-middle income country |
| title_short | The modified 5-item frailty index in total hip arthroplasty patients: a retrospective cohort from a low-middle income country |
| title_sort | modified 5 item frailty index in total hip arthroplasty patients a retrospective cohort from a low middle income country |
| topic | Total hip arthroplasty mFI-5 Frailty index Postoperative complications Low- and middle-income countries Geriatrics |
| url | https://doi.org/10.1186/s13018-025-05505-9 |
| work_keys_str_mv | AT usmanali themodified5itemfrailtyindexintotalhiparthroplastypatientsaretrospectivecohortfromalowmiddleincomecountry AT shahzilabdurrehmanmalik themodified5itemfrailtyindexintotalhiparthroplastypatientsaretrospectivecohortfromalowmiddleincomecountry AT bilaliqbal themodified5itemfrailtyindexintotalhiparthroplastypatientsaretrospectivecohortfromalowmiddleincomecountry AT aribahbhatti themodified5itemfrailtyindexintotalhiparthroplastypatientsaretrospectivecohortfromalowmiddleincomecountry AT sherbazkhan themodified5itemfrailtyindexintotalhiparthroplastypatientsaretrospectivecohortfromalowmiddleincomecountry AT shahryarnoordin themodified5itemfrailtyindexintotalhiparthroplastypatientsaretrospectivecohortfromalowmiddleincomecountry AT anumali themodified5itemfrailtyindexintotalhiparthroplastypatientsaretrospectivecohortfromalowmiddleincomecountry AT usmanali modified5itemfrailtyindexintotalhiparthroplastypatientsaretrospectivecohortfromalowmiddleincomecountry AT shahzilabdurrehmanmalik modified5itemfrailtyindexintotalhiparthroplastypatientsaretrospectivecohortfromalowmiddleincomecountry AT bilaliqbal modified5itemfrailtyindexintotalhiparthroplastypatientsaretrospectivecohortfromalowmiddleincomecountry AT aribahbhatti modified5itemfrailtyindexintotalhiparthroplastypatientsaretrospectivecohortfromalowmiddleincomecountry AT sherbazkhan modified5itemfrailtyindexintotalhiparthroplastypatientsaretrospectivecohortfromalowmiddleincomecountry AT shahryarnoordin modified5itemfrailtyindexintotalhiparthroplastypatientsaretrospectivecohortfromalowmiddleincomecountry AT anumali modified5itemfrailtyindexintotalhiparthroplastypatientsaretrospectivecohortfromalowmiddleincomecountry |