Frailty Syndrome in Patients with Carotid Disease: Simplifying How We Calculate Frailty

Viraj Pandit, Muhammad Zeeshan, Peter R. Nelson, Muhammad Hamidi, Sandeep Jhajj, Ashton Lee, Bradley Trinidad, Kaoru Goshima, Vernon Horst, Craig Weinkauf, Wei Zhou, Tze Woei Tan

Research output: Contribution to journalArticlepeer-review

16 Scopus citations


Background: Frailty syndrome is an established predictor of adverse outcomes after carotid surgery. Recently, a modified 5-factor National Surgical Quality Improvement Program frailty index has been used; however, its utility in vascular procedures is unclear. The aim of our study was to compare the 5-factor modified frailty index (mFI-5) with the 11-factor modified frailty index (mFI-11) regarding value and predictive ability for mortality, postoperative infection, and unplanned 30-day readmission. Methods: The mFI was calculated by dividing the number of factors present for a patient by the number of available factors for which there were no missing data. Spearman rho test was used to assess the correlation between the mFI-5 and mFI-11. Predictive models, using both unadjusted and adjusted logistic regressions, were created for each outcome for carotid endarterectomy using 2005–2012 National Surgical Quality Improvement Program data, the last year all mFI-11 variables existed. Results: A total of 36,000 patients were included with mean age of 74.6 ± 5.9 years, complication rate of 10.7%, mortality rate of 3.1%, and readmission rate of 6.2%. Correlation between mFI-5 and mFI-11 was above 0.9 across all outcomes for patients. mFI-5 had strong predictive ability for mortality, postoperative complications, and 30-day readmission. Conclusions: The mFI-5 and mFI-11 are equally effective predictors of postoperative outcomes in patients undergoing carotid endarterectomy. mFI-5 is a strong predictor of postoperative complications, mortality, and 30-day readmission.

Original languageEnglish (US)
Pages (from-to)159-165
Number of pages7
JournalAnnals of Vascular Surgery
StatePublished - Jan 2020

ASJC Scopus subject areas

  • Surgery
  • Cardiology and Cardiovascular Medicine


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