{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T12:32:10Z","timestamp":1790857930366,"version":"4.1.0"},"reference-count":29,"publisher":"Springer Science and Business Media LLC","issue":"10","license":[{"start":{"date-parts":[[2024,7,24]],"date-time":"2024-07-24T00:00:00Z","timestamp":1721779200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,7,24]],"date-time":"2024-07-24T00:00:00Z","timestamp":1721779200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100006034","name":"University of Southern California","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100006034","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Surg Endosc"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Gastric cancer is the 5th most common malignancy worldwide. Surgical treatment for the disease can often be highly morbid, especially in elderly patients. The modified 5-item frailty index (mFI-5), a recently developed tool for assessing patient frailty, has been shown to be an effective predictor of post-operative outcomes in various surgical fields. This study aims to assess the utility of the mFI-5 in predicting adverse postoperative outcomes following gastrectomy for gastric cancer.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>The National Surgical Quality Improvement Program (NSQIP) database was queried for patients who underwent partial or total gastrectomy for gastric cancer between 2011 and 2021. The mFI-5 score was calculated based on the presence of hypertension, congestive heart failure, diabetes mellitus, chronic obstructive pulmonary disease, and partially or fully dependent functional status. Patients were stratified into 3 groups according to mFI-5 score (mFI-5\u2009=\u20090, mFI-5\u2009=\u20091, mFI-5\u2009\u2265\u20092). Univariate analysis and multivariate logistic regression were used to evaluate the association between mFI-5 score and post-operative outcomes.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>7438 patients were identified (mFI-5\u2009=\u20090: 3032, mFI-5\u2009=\u20091: 2805, mFI-5\u2009\u2265\u20092: 1601). mFI-5\u2009\u2265\u20092 was an independent predictor of overall complications (OR 1.43, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), serious complications (OR 1.42, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), pneumonia (OR 1.43, <jats:italic>p<\/jats:italic>\u2009=\u20090.010), MI (OR 2.91, <jats:italic>p<\/jats:italic>\u2009=\u20090.005), and readmission within 30\u00a0days (OR 1.33, <jats:italic>p<\/jats:italic>\u2009=\u20090.008). Patients with higher frailty were more likely to experience unplanned intubation (OR 2.06, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001; OR 2.47, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), failure to wean from the ventilator (OR 1.68, <jats:italic>p<\/jats:italic>\u2009=\u20090.003; OR 2.00, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), acute renal failure (OR 3.25, <jats:italic>p<\/jats:italic>\u2009=\u20090.003; OR 3.27, <jats:italic>p<\/jats:italic>\u2009=\u20090.005), 30-day mortality (OR 1.73, <jats:italic>p<\/jats:italic>\u2009=\u20090.009; OR 1.94, <jats:italic>p<\/jats:italic>\u2009=\u20090.004), and non-home discharge (OR 1.34, <jats:italic>p<\/jats:italic>\u2009=\u20090.001; OR 1.74, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) relative to non-frail patients.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Higher frailty, as indicated by an increased mFI-5 score, raises the risk of serious post-operative complications in patients with gastric cancer undergoing gastrectomy. The mFI-5 has the potential to help identify high-risk patients and enhance pre-operative discussions and optimization.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Graphical abstract<\/jats:title>\n                \n              <\/jats:sec>","DOI":"10.1007\/s00464-024-11103-3","type":"journal-article","created":{"date-parts":[[2024,7,24]],"date-time":"2024-07-24T15:10:19Z","timestamp":1721833819000},"page":"5922-5928","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Utility of the mFI-5 as a predictor of post-operative outcomes following gastrectomy for gastric cancer: an ACS-NSQIP analysis"],"prefix":"10.1007","volume":"38","author":[{"given":"Ashley","family":"Tran","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luke R.","family":"Putnam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John C.","family":"Lipham","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon","family":"Shiraga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,7,24]]},"reference":[{"key":"11103_CR1","doi-asserted-by":"publisher","first-page":"167","DOI":"10.6004\/jnccn.2022.0008","volume":"20","author":"JA Ajani","year":"2022","unstructured":"Ajani JA, D\u2019Amico TA, Bentrem DJ et al (2022) Gastric Cancer, Version 2.2022 NCCN Clinical Practice Guidelines in Oncology. J Natl Compreh Cancer Netw 20:167\u2013192","journal-title":"J Natl Compreh Cancer Netw"},{"key":"11103_CR2","doi-asserted-by":"publisher","first-page":"635","DOI":"10.1016\/S0140-6736(20)31288-5","volume":"396","author":"EC Smyth","year":"2020","unstructured":"Smyth EC, Nilsson M, Grabsch HI et al (2020) Gastric cancer. Lancet 396:635\u2013648","journal-title":"Lancet"},{"key":"11103_CR3","doi-asserted-by":"publisher","first-page":"1005","DOI":"10.1016\/j.annonc.2022.07.004","volume":"33","author":"F Lordick","year":"2022","unstructured":"Lordick F, Carneiro F, Cascinu S et al (2022) Gastric cancer: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up. Ann Oncol 33:1005\u20131020","journal-title":"Ann Oncol"},{"key":"11103_CR4","doi-asserted-by":"publisher","first-page":"446","DOI":"10.1001\/jamasurg.2022.0182","volume":"157","author":"GZ Li","year":"2022","unstructured":"Li GZ, Doherty GM, Wang J (2022) Surgical management of gastric cancer. JAMA Surg 157:446","journal-title":"JAMA Surg"},{"key":"11103_CR5","doi-asserted-by":"publisher","first-page":"2713","DOI":"10.1177\/00031348221148359","volume":"89","author":"CE Hall","year":"2023","unstructured":"Hall CE, Maegawa F, Patel AD et al (2023) Management of gastric cancer. Am Surg 89:2713\u20132720","journal-title":"Am Surg"},{"key":"11103_CR6","unstructured":"National Comprehensive Cancer Network (2024) NCCN Guidelines - Gastric Cancer. https:\/\/www.nccn.org\/professionals\/physician_gls\/pdf\/gastric.pdf. Accessed 10 April 2024"},{"key":"11103_CR7","doi-asserted-by":"publisher","first-page":"3008","DOI":"10.1245\/s10434-014-3664-z","volume":"21","author":"WA Papenfuss","year":"2014","unstructured":"Papenfuss WA, Kukar M, Oxenberg J et al (2014) Morbidity and mortality associated with gastrectomy for gastric cancer. Ann Surg Oncol 21:3008\u20133014","journal-title":"Ann Surg Oncol"},{"key":"11103_CR8","doi-asserted-by":"publisher","first-page":"1554","DOI":"10.1007\/s11605-016-3195-y","volume":"20","author":"AN Martin","year":"2016","unstructured":"Martin AN, Das D, Turrentine FE et al (2016) Morbidity and mortality after gastrectomy: identification of modifiable risk factors. J Gastrointest Surg 20:1554\u20131564","journal-title":"J Gastrointest Surg"},{"key":"11103_CR9","doi-asserted-by":"publisher","first-page":"752","DOI":"10.1016\/S0140-6736(12)62167-9","volume":"381","author":"A Clegg","year":"2013","unstructured":"Clegg A, Young J, Iliffe S et al (2013) Frailty in elderly people. Lancet 381:752\u2013762","journal-title":"Lancet"},{"key":"11103_CR10","doi-asserted-by":"publisher","first-page":"M146","DOI":"10.1093\/gerona\/56.3.M146","volume":"56","author":"LP Fried","year":"2001","unstructured":"Fried LP, Tangen CM, Walston J et al (2001) Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci 56:M146\u2013M157","journal-title":"J Gerontol A Biol Sci Med Sci"},{"key":"11103_CR11","doi-asserted-by":"publisher","first-page":"173","DOI":"10.1016\/j.jamcollsurg.2017.11.005","volume":"226","author":"S Subramaniam","year":"2018","unstructured":"Subramaniam S, Aalberg JJ, Soriano RP et al (2018) New 5-Factor Modified Frailty Index using American College of Surgeons NSQIP Data. J Am Coll Surg 226:173\u2013181","journal-title":"J Am Coll Surg"},{"key":"11103_CR12","doi-asserted-by":"publisher","first-page":"507","DOI":"10.1016\/j.jss.2022.10.045","volume":"283","author":"N Balasundaram","year":"2023","unstructured":"Balasundaram N, Chandra I, Sunilkumar VT et al (2023) Frailty Index (mFI-5) predicts resource utilization after nonruptured endovascular aneurysm repair. J Surg Res 283:507\u2013513","journal-title":"J Surg Res"},{"key":"11103_CR13","doi-asserted-by":"publisher","first-page":"e626","DOI":"10.1016\/j.wneu.2018.12.168","volume":"124","author":"DJ Weaver","year":"2019","unstructured":"Weaver DJ, Malik AT, Jain N et al (2019) The Modified 5-Item Frailty Index: a concise and useful tool for assessing the impact of frailty on postoperative morbidity following elective posterior lumbar fusions. World Neurosurg 124:e626\u2013e632","journal-title":"World Neurosurg"},{"key":"11103_CR14","volume":"13","author":"NP Patel","year":"2023","unstructured":"Patel NP, Elali F, Coban D et al (2023) The 5-factor modified Frailty Index (mFI-5) predicts adverse outcomes after elective Anterior Lumbar Interbody Fusion (ALIF). N Am Spine Soc J 13:100189","journal-title":"N Am Spine Soc J"},{"key":"11103_CR15","doi-asserted-by":"publisher","first-page":"697","DOI":"10.1016\/j.amjsurg.2023.07.039","volume":"226","author":"AZ Agathis","year":"2023","unstructured":"Agathis AZ, Bangla VG, Divino CM (2023) Role of mFI-5 in predicting geriatric outcomes in laparoscopic cholecystectomy. Am J Surg 226:697\u2013702","journal-title":"Am J Surg"},{"key":"11103_CR16","doi-asserted-by":"publisher","first-page":"307","DOI":"10.1186\/s12957-023-03186-4","volume":"21","author":"L Huang","year":"2023","unstructured":"Huang L, Li Z, Jian M et al (2023) Application of MFI-5 in severe complications and unfavorable outcomes after radical resection of colorectal cancer. World J Surg Oncol 21:307","journal-title":"World J Surg Oncol"},{"key":"11103_CR17","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000036065","volume":"102","author":"S An","year":"2023","unstructured":"An S, Eo W, Lee S (2023) Prognostic significance of a five-factor modified frailty index in patients with gastric cancer undergoing curative-intent resection: a cohort study. Medicine 102:e36065","journal-title":"Medicine"},{"key":"11103_CR18","doi-asserted-by":"publisher","first-page":"750","DOI":"10.1111\/ggi.14648","volume":"23","author":"Y Maeda","year":"2023","unstructured":"Maeda Y, Eto K, Yoshida N et al (2023) The 5-factor modified frailty index is a novel predictive marker of death from other diseases after curative gastrectomy for gastric cancer. Geriatr Gerontol Int 23:750\u2013756","journal-title":"Geriatr Gerontol Int"},{"key":"11103_CR19","doi-asserted-by":"publisher","first-page":"10","DOI":"10.21037\/tgh.2020.01.07","volume":"6","author":"KA Zorbas","year":"2021","unstructured":"Zorbas KA, Velanovich V, Esnaola NF et al (2021) Modified frailty index predicts complications and death after non-bariatric gastrectomies. Transl Gastroenterol Hepatol 6:10\u201310","journal-title":"Transl Gastroenterol Hepatol"},{"key":"11103_CR20","doi-asserted-by":"publisher","first-page":"9117","DOI":"10.2147\/CMAR.S336023","volume":"13","author":"Y Meng","year":"2021","unstructured":"Meng Y, Zhao P, Yong R (2021) Modified Frailty Index independently predicts postoperative pulmonary infection in elderly patients undergoing radical gastrectomy for gastric cancer. Cancer Manag Res 13:9117\u20139126","journal-title":"Cancer Manag Res"},{"key":"11103_CR21","doi-asserted-by":"publisher","first-page":"3837","DOI":"10.1007\/s00268-020-05691-z","volume":"44","author":"T Osaki","year":"2020","unstructured":"Osaki T, Saito H, Shimizu S et al (2020) Modified Frailty Index is useful in predicting non-home discharge in elderly patients with gastric cancer who undergo gastrectomy. World J Surg 44:3837\u20133844","journal-title":"World J Surg"},{"key":"11103_CR22","doi-asserted-by":"publisher","first-page":"67","DOI":"10.1016\/j.jgo.2021.06.010","volume":"13","author":"J-R Jeong","year":"2022","unstructured":"Jeong J-R, Choi J-W, Ryu S-Y et al (2022) Relationship between frailty and mortality after gastrectomy in older patients with gastric cancer. J Geriatr Oncol 13:67\u201373","journal-title":"J Geriatr Oncol"},{"key":"11103_CR23","doi-asserted-by":"publisher","first-page":"1420","DOI":"10.1177\/0003134820952438","volume":"87","author":"S Subramaniam","year":"2021","unstructured":"Subramaniam S, Aalberg JJ, Soriano RP et al (2021) The 5-Factor Modified Frailty Index in the geriatric surgical population. Am Surg 87:1420\u20131425","journal-title":"Am Surg"},{"key":"11103_CR24","doi-asserted-by":"publisher","first-page":"1307","DOI":"10.1177\/15589447221093728","volume":"18","author":"AM Gordon","year":"2023","unstructured":"Gordon AM, Conway CA, Sheth BK et al (2023) The 5-Item Modified Frailty Index for risk stratification of patients undergoing total elbow arthroplasty. Hand (N Y) 18:1307\u20131313","journal-title":"Hand (N Y)"},{"key":"11103_CR25","doi-asserted-by":"publisher","first-page":"135","DOI":"10.1007\/s10029-023-02905-w","volume":"28","author":"AZ Agathis","year":"2024","unstructured":"Agathis AZ, Bangla VG, Divino CM (2024) Assessing the mFI-5 frailty score and functional status in geriatric patients undergoing inguinal hernia repairs. Hernia 28:135\u2013145","journal-title":"Hernia"},{"key":"11103_CR26","first-page":"520","volume":"42","author":"D Mascia","year":"2023","unstructured":"Mascia D, Santoro A, Saracino C et al (2023) Five-factors Modified Frailty Index role as predictors of outcomes after proximal abdominal aortic aneurysms. Int Angiol 42:520\u2013527","journal-title":"Int Angiol"},{"key":"11103_CR27","doi-asserted-by":"publisher","first-page":"1971","DOI":"10.1007\/s11605-023-05743-4","volume":"27","author":"NA Clements","year":"2023","unstructured":"Clements NA, Gaskins JT, Martin RCG (2023) Predictive ability of comorbidity indices for surgical morbidity and mortality: a systematic review and meta-analysis. J Gastrointest Surg 27:1971\u20131987","journal-title":"J Gastrointest Surg"},{"key":"11103_CR28","doi-asserted-by":"publisher","first-page":"1376","DOI":"10.1016\/S0140-6736(19)31785-4","volume":"394","author":"E Dent","year":"2019","unstructured":"Dent E, Martin FC, Bergman H et al (2019) Management of frailty: opportunities, challenges, and future directions. Lancet 394:1376\u20131386","journal-title":"Lancet"},{"key":"11103_CR29","doi-asserted-by":"publisher","first-page":"1365","DOI":"10.1016\/S0140-6736(19)31786-6","volume":"394","author":"EO Hoogendijk","year":"2019","unstructured":"Hoogendijk EO, Afilalo J, Ensrud KE et al (2019) Frailty: implications for clinical practice and public health. Lancet 394:1365\u20131375","journal-title":"Lancet"}],"container-title":["Surgical Endoscopy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00464-024-11103-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00464-024-11103-3\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00464-024-11103-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,10,8]],"date-time":"2024-10-08T04:03:16Z","timestamp":1728360196000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00464-024-11103-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,24]]},"references-count":29,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2024,10]]}},"alternative-id":["11103"],"URL":"https:\/\/doi.org\/10.1007\/s00464-024-11103-3","relation":{},"ISSN":["0930-2794","1432-2218"],"issn-type":[{"value":"0930-2794","type":"print"},{"value":"1432-2218","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,7,24]]},"assertion":[{"value":"17 April 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 July 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 July 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Tran, Putnam, Lipham, and Shiraga have no conflicts of interest or financial ties to disclose.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Disclosures"}}]}}