{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T09:11:56Z","timestamp":1790413916918,"version":"4.1.0"},"reference-count":23,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2023,12,8]],"date-time":"2023-12-08T00:00:00Z","timestamp":1701993600000},"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":[[2024,5]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Major lower extremity amputation (LEA) is associated with significant morbidity and mortality. The modified frailty index (mFI-5) has been used to predict outcomes including ambulation and mortality after LEA. It remains unknown for which patient demographics the mFI-5 is a reliable predictor.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was a retrospective review of all patients who underwent a first-time major LEA at our institution from 2015 to 2022. Patients were stratified into 2 risk groups based on their mFI-5 score: non-frail (mFI&lt;3) and frail (mFI\u22653) and assessed on outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Our sample consisted of 687 patients of whom 134 (19.6%) were considered frail and 551 (80.4%) were considered non-frail. A higher mFI-5 is associated with decreased ambulation rates (OR: 0.565, P = .004), increased hospital readmission (OR: 1.657, P = .021), and increased mortality (OR: 2.101, P = .001) following major LEA. In African American patients, frail and non-frail patients differed on readmission at 90 days ( P = .008), mortality at 1 year ( P = .001), ambulatory status ( P &lt; .001), and prosthesis use ( P = .023). In male patients, frail and non-frail patients differed on readmission at 90 days ( P = .019), death at 1 year ( P = .001), and ambulatory status ( P = .002). In Caucasian patients and female patients, frail and non-frail patients did not differ significantly on outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>The mFI-5 is a valuable predictor of outcomes following major LEA, specifically in males and African American patients. Moreover, surgeons should consider using frailty status to risk stratify patients and inform treatment plans.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00031348231220570","type":"journal-article","created":{"date-parts":[[2023,12,8]],"date-time":"2023-12-08T06:31:55Z","timestamp":1702017115000},"page":"1030-1036","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["Modified Frailty Index Helps Predict Mortality and Ambulation Differences Between Genders and Racial Differences Following Major Lower Extremity Amputation"],"prefix":"10.1177","volume":"90","author":[{"given":"Maria N.","family":"Som","sequence":"first","affiliation":[{"name":"Department of Vascular Surgery, University of Maryland Medical Center, Baltimore, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalie T.","family":"Chao","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, University of Maryland Medical Center, Baltimore, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allison","family":"Karwoski","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, University of Maryland Medical Center, Baltimore, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luke T.","family":"Pitsenbarger","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, University of Maryland Medical Center, Baltimore, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eleanor","family":"Dunlap","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, University of Maryland Medical Center, Baltimore, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khanjan H.","family":"Nagarsheth","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, University of Maryland Medical Center, Baltimore, MD, 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