{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T01:02:31Z","timestamp":1793062951138,"version":"4.5.0"},"reference-count":40,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2024,4,23]],"date-time":"2024-04-23T00:00:00Z","timestamp":1713830400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2024,4,23]],"date-time":"2024-04-23T00:00:00Z","timestamp":1713830400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The modified frailty index (mFI\u20105) is a National Surgical Quality Improvement Program\u2010derived 5\u2010factor index that has been proven to reflect frailty and predict morbidity and mortality. We hypothesize that mFI\u20105 is a valid predictive measure in the transoral robotic surgery (TORS) population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Retrospective study utilizing the TriNetX US\u2010collaborative health records network querying for TORS patients. Cohorts were stratified by mFI\u20105 score which uses five ICD\u201010 codes: nonindependent functional status, hypertension, obstructive respiratory disease, heart failure, and diabetes mellitus. Cohorts were matched by age using propensity score matching. Outcome measures included survival, infection, pneumonia, tracheostomy dependence, and percutaneous endoscopic gastrostomy dependence. Reported odds ratios were normalized to mFI\u20105\u2009=\u20090.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 9,081 patients were included in the final analysis. Greater mFI\u20105 scores predicted decreased survival and increased incidence of postoperative infection and pneumonia. Odds of 5\u2010year mortality were 1.93 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0003) for mFI\u20105\u2009=\u20092 and 1.90 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0002) for mFI\u20105\u2009=\u20093. Odds of 2\u2010year mortality were 1.25 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0125) for mFI\u20105\u2009=\u20091, 1.58 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0002) for mFI\u20105\u2009=\u20092, and 1.87 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003) for mFI\u20105\u2009=\u20093. Odds of postoperative infection were 1.51 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.02) for mFI\u20105\u2009=\u20092 and 1.78 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.05) for mFI\u20105\u2009=\u20093. Two\u2010year odds of developing pneumonia were 1.69 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0001) for mFI\u20105\u2009=\u20092 and 2.84 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001) for mFI\u20105\u2009=\u20093. Two\u2010month odds of pneumonia were 1.50 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0259) for mFI\u20105\u2009=\u20092 and 2.55 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0037) for mFI\u20105\u2009=\u20093. mFI\u20105\u2009=\u20094 or 5 had too few patients to analyze. Using polynomial regression to model age versus incident 5\u2010year post\u2010TORS death (\n                      <jats:italic>R<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090.99), mFI\u20105 scores better predicted survival than age alone.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study demonstrates that mFI\u20105 predicts mortality, pneumonia, and postoperative infection independently of age.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>\n                      4\n                      <jats:italic>Laryngoscope<\/jats:italic>\n                      , 134:4278\u20134283, 2024\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lary.31458","type":"journal-article","created":{"date-parts":[[2024,4,23]],"date-time":"2024-04-23T05:15:17Z","timestamp":1713849317000},"page":"4278-4283","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Modified Frailty Index Associates With Transoral Robotic Surgery Complications and Survival: A National Database Study"],"prefix":"10.1002","volume":"134","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6170-7224","authenticated-orcid":false,"given":"Amiti","family":"Jain","sequence":"first","affiliation":[{"name":"Sidney Kimmel Medical College at Thomas Jefferson University  Philadelphia Pennsylvania USA"},{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery Thomas Jefferson University Hospital  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zachary 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