BACKGROUND Frailty indices may represent useful decision support tools to optimize modifiable drivers of quality and cost in neurosurgical care. However, classic indices are cumbersome to calculate and frequently require unavailable data. Recently, a more lean 5-factor modified frailty index (mFI-5) was introduced, but it has not yet been rigorously applied to brain tumor patients. OBJECTIVE To investigate the predictive value of the mFI-5 on length of stay (LOS), complications, and charges in surgical brain tumor patients. METHODS We retrospectively reviewed data for brain tumor patients who underwent primary surgery from 2017 to 2018. Bivariate (ANOVA) and multivariate (logistic and linear regression) analyses assessed the predictive power of the mFI-5 on postoperative outcomes. RESULTS Our cohort included 1692 patients with a mean age of 55.5 yr and mFI-5 of 0.80. Mean intensive care unit (ICU) and total LOS were 1.69 and 5.24 d, respectively. Mean pulmonary embolism (PE)/deep vein thrombosis (DVT), physiological/metabolic derangement, respiratory failure, and sepsis rates were 7.2%, 1.1%, 1.6%, and 1.7%, respectively. Mean total charges were $42 331. On multivariate analysis, each additional point on the mFI-5 was associated with a 0.32- and 1.38-d increase in ICU and total LOS, respectively; increased odds of PE/DVT (odds ratio (OR): 1.50), physiological/metabolic derangement (OR: 3.66), respiratory failure (OR: 1.55), and sepsis (OR: 2.12); and an increase in total charges of $5846. CONCLUSION The mFI-5 is a pragmatic and actionable tool which predicts LOS, complications, and charges in brain tumor patients. It may guide future efforts to risk-stratify patients with subsequent impact on postoperative outcomes.

中文翻译：

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用 5 因素修正虚弱指数预测脑肿瘤患者的术后结果

背景虚弱指数可以代表有用的决策支持工具来优化神经外科护理中质量和成本的可修改驱动因素。然而，经典指数计算起来很麻烦，而且经常需要不可用的数据。最近，引入了更精益的5因子修正虚弱指数（mFI-5），但尚未严格应用于脑肿瘤患者。目的 探讨 mFI-5 对手术脑肿瘤患者住院时间（LOS）、并发症和费用的预测价值。方法 我们回顾性审查了 2017 年至 2018 年接受初次手术的脑肿瘤患者的数据。双变量（ANOVA）和多变量（逻辑和线性回归）分析评估了 mFI-5 对术后结果的预测能力。结果 我们的队列包括 1692 名平均年龄为 55 岁的患者。5 年和 mFI-5 为 0.80。平均重症监护病房 (ICU) 和总 LOS 分别为 1.69 天和 5.24 天。平均肺栓塞 (PE)/深静脉血栓形成 (DVT)、生理/代谢紊乱、呼吸衰竭和败血症的发生率分别为 7.2%、1.1%、1.6% 和 1.7%。平均总费用为 42 331 美元。在多变量分析中，mFI-5 上每增加一个点，ICU 和总 LOS 分别增加 0.32 天和 1.38 天；PE/DVT（OR：1.50）、生理/代谢紊乱（OR：3.66）、呼吸衰竭（OR：1.55）和败血症（OR：2.12）的几率增加；总费用增加了 5846 美元。结论 mFI-5 是一种实用且可操作的工具，可预测脑肿瘤患者的 LOS、并发症和费用。