{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T23:38:24Z","timestamp":1789256304112,"version":"build-2803163510"},"reference-count":39,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,1,27]],"date-time":"2025-01-27T00:00:00Z","timestamp":1737936000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To investigate the consistency of associations between modified frailty index\u20105 (mFI\u20105) and postoperative adverse outcomes in head and neck cancer (HNC) reconstruction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>American College of Surgeons National Surgical Quality Improvement Program (ACS\u2010NSQIP) database from 2017 to 2022 was utilized to identify HNC patients undergoing locoregional or microvascular free tissue transfers. Kaplan\u2013Meier estimates and multivariable Cox regression analyses were utilized to compare risk of infections, bleeding, readmissions, reoperations, major adverse cardiovascular events (MACE), and mortality within the first postoperative month for each mFI\u20105 score with mFI\u20105\u2009=\u20090 as reference. Further analyses investigated associations between individual mFI\u20105 components and the outcomes of interest.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We included 5,573 patients (median age: 64; 31.5% female), 63% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20093,519) of whom underwent microvascular free tissue transfers. Unadjusted univariate analyses associated higher mFI\u20105 scores with longer hospital stays. In locoregional tissue transfers, adjusted hazard ratios (aHRs) for reoperation were 1.37 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.03) for mFI\u20105\u2009=\u20091 and 2.19 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.03) for mFI\u20105\u2009\u2265\u20093. In microvascular free tissue transfers, aHRs for MACE were 1.93 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.04) for mFI\u20105\u2009=\u20092 and 6.53 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) for mFI\u20105\u2009\u2265\u20093, while aHRs for mortality was 3.88 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.04) for mFI\u20105\u2009\u2265\u20093. No associations were observed between increasing mFI\u20105 scores and increased relative risk of infection, bleeding, or readmission. Individual component analysis associated congestive heart failure with aHRs of 3.92 (1.84\u20138.35;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) for MACE and 5.30 (2.03\u201313.88;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) for mortality. Additionally, COPD was associated with an aHR of 1.39 (1.16\u20131.67;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) for infections.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The associations of higher mFI\u20105 scores with postoperative adverse outcomes following oncoplastic head and neck reconstruction were inconsistent and possibly driven by individual effects of its components.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>\n                      3\n                      <jats:italic>Laryngoscope<\/jats:italic>\n                      , 135:2342\u20132352, 2025\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lary.32008","type":"journal-article","created":{"date-parts":[[2025,1,28]],"date-time":"2025-01-28T00:34:53Z","timestamp":1738024493000},"page":"2342-2352","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Inconsistent Associations of Modified Frailty Index\u20105 With Adverse Head and Neck Reconstruction Outcomes"],"prefix":"10.1002","volume":"135","author":[{"given":"Doruk","family":"Orgun","sequence":"first","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Department of Surgery University of Wisconsin School of Medicine and Public Health  Madison Wisconsin U.S.A."},{"name":"Department of Plastic and Reconstructive Surgery The Jikei University School of Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline C.","family":"Bay","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Department of Surgery University of Wisconsin School of Medicine and Public Health  Madison Wisconsin U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristine M.","family":"Carbullido","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Department of Surgery University of Wisconsin School of Medicine and Public Health  Madison Wisconsin U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aaron M.","family":"Wieland","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology\u2014Head and Neck Surgery, Department of Surgery University of Wisconsin School of Medicine and Public Health  Madison Wisconsin U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brett F.","family":"Michelotti","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Department of Surgery University of Wisconsin School of Medicine and Public Health  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