{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T17:48:17Z","timestamp":1786470497394,"version":"build-2736575974"},"reference-count":52,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T00:00:00Z","timestamp":1776297600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T00:00:00Z","timestamp":1776297600000},"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":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective(s)<\/jats:title>\n                    <jats:p>Current preoperative risk stratification for uvulopalatopharyngoplasty (UPPP) primarily relies on anatomic and disease\u2010severity measures, which do not capture physiologic reserve or vulnerability to postoperative complications. This study aimed to compare the predictive performance of the risk analysis index (RAI) and the modified frailty index\u20105 (mFI\u20105) in stratifying postoperative risk among patients undergoing UPPP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Adult patients who underwent UPPP between 2005 and 2020 were identified. Frailty was assessed, and associations with postoperative complications, length of stay, discharge disposition, and mortality were evaluated. Multivariable regression and receiver operating characteristic analysis were conducted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 2129 patients were included and severe frailty (RAI\u2009&gt;\u200931) was strongly associated with adverse postoperative outcomes, including Clavien\u2013Dindo (CD) II complications (OR 21.3, 95% CI 3.7\u2013123.8), CD IV (OR 4.6, 95% CI 2.0\u201310.6), extended length of stay (eLOS) (OR 29.4, 95% CI 5.4\u2013160), non\u2010home discharge (NHD) (OR 6.1, 95% CI 3.0\u201312.6), and deep surgical site infection (DSSI) (OR 17.5, 95% CI 1.7\u2013176.3) (all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). The mFI\u20105 predicted CD II, eLOS, and NHD but not CD IV or DSSI among severely frail patients (mFI\u20105\u2009&gt;\u20093). RAI consistently outperformed mFI\u20105 across outcomes, including mortality (AUC 0.813 vs. 0.580), CD II (0.784 vs. 0.652), CD IV (0.704 vs. 0.654), eLOS (0.767 vs. 0.669), and NHD (0.767 vs. 0.618).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Although both RAI and mFI\u20105 are associated with postoperative outcomes following UPPP, RAI provides superior discrimination for mortality and major morbidity. These findings support the incorporation of RAI into preoperative risk stratification for sleep surgery to better inform perioperative planning and resource allocation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>3.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lary.70571","type":"journal-article","created":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T11:39:08Z","timestamp":1776339548000},"page":"3815-3825","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Risk Analysis Index Versus\n                    <scp>mFI<\/scp>\n                    \u20105 for Predicting Outcomes After Uvulopalatopharyngoplasty"],"prefix":"10.1002","volume":"136","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4841-6366","authenticated-orcid":false,"given":"Akshay","family":"Warrier","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery Rutgers New Jersey Medical School  Newark New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ariana","family":"Shaari","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Stony Brook University  New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0794-041X","authenticated-orcid":false,"given":"Aman M.","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery Rutgers New Jersey Medical School  Newark New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6299-503X","authenticated-orcid":false,"given":"Christian","family":"Bowers","sequence":"additional","affiliation":[{"name":"Bowers Frailty and Surgical Outcomes Lab  Flint Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth","family":"Yan","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery Rutgers New Jersey Medical School  Newark New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,16]]},"reference":[{"issue":"9","key":"e_1_2_9_2_1","article-title":"Obstructive Sleep Apnea and Cardiovascular Morbidities: A Review Article","volume":"12","author":"Rana 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