{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T17:16:42Z","timestamp":1790011002696,"version":"4.0.1"},"reference-count":53,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2021,5,11]],"date-time":"2021-05-11T00:00:00Z","timestamp":1620691200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2022,3]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To evaluate the impact of preoperative frailty on short\u2010term outcomes following complex head and neck surgeries (HNSs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Cross\u2010sectional database analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>American College of Surgeons National Surgical Quality Improvement Program (ACS\u2010NSQIP) database.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The 2005 to 2017 ACS\u2010NSQIP was queried for patients undergoing complex HNS. Five\u2010item modified frailty index (mFI) was calculated based on functional status and history of diabetes, chronic obstructive pulmonary disease, congestive heart failure, and chronic hypertension.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 2786 patients (73.1% male) with a mean age of 62.0 \u00b1 11.6 years were included. Compared to nonfrail patients (41.2%), patients with mFI \u22651 (58.8%) had shorter length of operation (\n                      <jats:italic>P<\/jats:italic>\n                      =. 021), longer length of stay (LOS) (\n                      <jats:italic>P<\/jats:italic>\n                      &lt;. 001), and higher rates of 30\u2010day reoperation (\n                      <jats:italic>P<\/jats:italic>\n                      =. 009), medical complications (\n                      <jats:italic>P<\/jats:italic>\n                      &lt;. 001), discharge to nonhome facility (DNHF) (\n                      <jats:italic>P<\/jats:italic>\n                      &lt;. 001), and mortality (\n                      <jats:italic>P<\/jats:italic>\n                      =. 047). These parameters remained statistically significant when compared across all individual mFI scores (all\n                      <jats:italic>P<\/jats:italic>\n                      &lt;. 05). After adjusting for age, sex, race, body mass index, smoking, and American Society of Anesthesiologists score via multivariate logistic regression, patients with mFI \u22651 were significantly more likely to undergo reoperation (odds ratio [OR], 1.39), surgical complications (OR, 1.19), medical complications (OR, 1.55), prolonged LOS (OR, 1.29), and DNHF (OR, 1.56) (all\n                      <jats:italic>P<\/jats:italic>\n                      &lt;. 05). Multivariate logistic regression also demonstrated that after adjusting for confounders, compared to patients with mFI = 1, patients with mFI = 2\u20105 (18.7%) were more likely to undergo shorter operations (OR, 0.74), have medical (OR, 1.46) or any complications (OR, 1.27), and have DNHF (OR, 1.62) (all\n                      <jats:italic>P<\/jats:italic>\n                      &lt;. 05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The 5\u2010point mFI can independently predict short\u2010term surgical outcomes following complex HNS. This simple and reliable metric can potentially lead to improved preoperative counseling and postoperative planning for complex HNS patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/01945998211010443","type":"journal-article","created":{"date-parts":[[2021,5,11]],"date-time":"2021-05-11T08:49:05Z","timestamp":1620722945000},"page":"482-489","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":42,"title":["Association Between 5\u2010Item Modified Frailty Index and Short\u2010term Outcomes in Complex Head and Neck Surgery"],"prefix":"10.1002","volume":"166","author":[{"given":"Khodayar","family":"Goshtasbi","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of California Irvine California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jack L.","family":"Birkenbeuel","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of California Irvine California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brandon M.","family":"Lehrich","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of California Irvine California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arash","family":"Abiri","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of California Irvine California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yarah M.","family":"Haidar","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of California Irvine California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tjoson","family":"Tjoa","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of California Irvine California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward C.","family":"Kuan","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of California Irvine California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,5,11]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cger.2010.08.009"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2006.10.018"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/014107689709032S07"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/56.3.M146"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1100\/tsw.2001.58"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2013.01.021"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2017.11.005"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-016-5253-7"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-010-1263-6"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.131.7.605"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/ans.15611"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.27339"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.urolonc.2015.06.002"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-012-2721-8"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-016-5715-0"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.26735"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12885-015-1800-1"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2009.09.031"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.28512"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599820955180"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.28373"},{"key":"e_1_2_8_23_1","unstructured":"StarkweatherJ MoskeAK.Multinomial logistic regression. 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