{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,7]],"date-time":"2026-11-07T20:36:03Z","timestamp":1794083763068,"version":"4.8.0"},"reference-count":18,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2020,10,1]],"date-time":"2020-10-01T00:00:00Z","timestamp":1601510400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The American Surgeon\u2122"],"published-print":{"date-parts":[[2020,10]]},"abstract":"<jats:p>Patient frailty indices are increasingly being utilized to anticipate post-operative complications. This study explores whether a 5-factor modified frailty index (mFI-5) is associated with outcomes following below-knee amputation (BKA). All BKAs in the vascular quality initiative (VQI) amputation registry from 2012-2017 were reviewed. Preoperative frailty status was determined with the mFI-5 which assigns one point each for history of diabetes, chronic obstructive pulmonary disease or active pneumonia, congestive heart failure, hypertension, and nonindependent functional status. Outcomes included 30-day mortality, unplanned return to odds ratio (OR), post-op myocardial infarction (MI), post-op SSI, all-cause complication, revision to higher level amputation, disposition status, and prosthetic use. 2040 BKAs were performed. Logistic regression showed an increasing mFI-5 score that was associated with higher risk of combined complications (OR 1.22, confidence interval [CI] 1.07-1.38, P &lt; .05), 30-day mortality (OR 1.60, CI 1.19-2.16, P &lt; .05), post-op MI (OR 1.79, CI 1.30-2.45, P &lt; .05), and failure of long-term prosthetic use (OR 1.17, CI 1.03-1.32, P &lt; .05). In the VQI, every one-point increase in mFI-5 is associated with an increased risk of 22% for combined complications, 60% for 30-day mortality, nearly 80% for post-op MI, and 17% for failure of prosthetic use in BKA patients. The mFI-5 frailty index should be incorporated into preoperative planning and risk stratification.<\/jats:p>","DOI":"10.1177\/0003134820964190","type":"journal-article","created":{"date-parts":[[2020,10,27]],"date-time":"2020-10-27T23:53:06Z","timestamp":1603842786000},"page":"1225-1229","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":22,"title":["5-Item Modified Frailty Index Predicts Outcomes After Below-Knee Amputation in the Vascular Quality Initiative Amputation Registry"],"prefix":"10.1177","volume":"86","author":[{"given":"James C.","family":"Andersen","sequence":"first","affiliation":[{"name":"Division of Vascular Surgery, Loma Linda University Health, Loma Linda, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua A.","family":"Gabel","sequence":"additional","affiliation":[{"name":"Division of Vascular Surgery, Loma Linda University Health, Loma Linda, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristyn A.","family":"Mannoia","sequence":"additional","affiliation":[{"name":"Division of Vascular Surgery, Loma Linda University Health, Loma Linda, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon C.","family":"Kiang","sequence":"additional","affiliation":[{"name":"Division of Vascular Surgery, Loma Linda University Health, Loma Linda, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheela T.","family":"Patel","sequence":"additional","affiliation":[{"name":"Division of Vascular Surgery, Loma Linda University Health, Loma Linda, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theodore H.","family":"Teruya","sequence":"additional","affiliation":[{"name":"Division of Vascular Surgery, Loma Linda University Health, Loma Linda, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Bianchi","sequence":"additional","affiliation":[{"name":"Division of Vascular Surgery, Loma Linda University Health, Loma Linda, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr","given":"Ahmed M.","family":"Abou-Zamzam","sequence":"additional","affiliation":[{"name":"Division of Vascular Surgery, Loma Linda University Health, Loma Linda, CA, 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