The 5-Factor Modified Frailty Index as a Predictor of Post-operative Complications in Males Undergoing Mastectomy

Background: The modified five-item frailty index (mFI-5) is a valuable tool for preoperative risk stratification of patients. There is a paucity of literature regarding the use of the mFI-5 in regard to males undergoing mastectomy. The aim of this study was to determine if the mFI-5 can predict negative postoperative outcomes. Methods: The 2005-2016 NSQIP database was queried to identify males aged 60 or older who underwent total mastectomy. Patient demographics, comorbidities, perioperative factors, and postoperative complications were collected. Patients were divided into cohorts based on whether their mFI-5 score was <2 or >2. Primary outcomes included prolonged postoperative length of stay (LOS), defined as greater than 75th percentile of the study population, and postoperative complications. Results: A total of 1,251 patients were identified, of whom 958 patients (76.6%) had mFI-5 scores <2 and 293 patients (23.4%) had mFI-5 scores >2. A significantly higher prevalence of medical complications occurred in the higher mFI group (6.1% vs. 1.6%, p<0.001). The mFI-5 was an independent risk factor for postoperative medical complications (OR 2.70, 95% CI, 1.28-5.68, p=0.009). Conclusion: This is the first study to evaluate the utility of mFI in predicting postoperative complications in males undergoing total mastectomies. We demonstrate that mFI has utility and is applicable as a risk stratification tool for males undergoing mastectomy.