{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T00:54:44Z","timestamp":1789865684784,"version":"4.0.1"},"reference-count":36,"publisher":"SAGE Publications","issue":"9","license":[{"start":{"date-parts":[[2025,9,18]],"date-time":"2025-09-18T00:00:00Z","timestamp":1758153600000},"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":["Hand (New York, N,Y.)"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Digit replantation has a significant risk of postoperative complications including an estimated reoperation rate around 14%. This study evaluates the modified frailty index 5 (mFI-5) in predicting postoperative complications including reoperation for digit replantation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>The American College of Surgeons\u2019 National Surgical Quality Improvement Program database (2007-2019) was queried to identify patients who underwent upper extremity blood vessel repair distal to the wrist. Demographics, patient characteristics, mFI-5 scores, and all complications, including reoperation and readmission, were analyzed using univariate and multivariate analyses to identify associations between mFI-5 and complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      We identified 1336 patients who underwent digit replantation. Of those, 99 patients (7.4%) had mFI-5 \u2265 3. Frail patients were defined as having mFI-5 \u2265 3 based on prior literature. Higher mFI-5 scores correlated with increased rates of all-cause complications (mFI-5 \u2265 3: 51.5% vs mFI-5 = 0: 9.2%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001), readmission (mFI-5 \u2265 3: 15.8% vs mFI-5 = 0: 2.2%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001), and reoperation (mFI-5 \u2265 3: 8.8% vs mFI-5 = 0: 3.1%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001). Multivariate analysis indicated that an mFI-5 score \u2265 3 significantly increased the rates of any complication (odds ratio [OR] = 9.1, 95% confidence interval [CI], 3.9-21.2,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001), mortality (OR = 5.4, 95% CI, 1.1-27.0,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .04), surgical complications (OR = 7.5, 95% CI, 2.5-22.9,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001), and medical complications (OR = 13.4, 95% CI, 3.9-46.7,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001). These patients also had lower odds of home discharge (OR = 0.35, 95% CI, 0.22-0.56,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001) and higher odds of unplanned readmission (OR = 1.4, 95% CI, 1.3-1.5,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001) compared with those with mFI-5 = 0.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>The mFI-5 is an effective tool for predicting adverse outcomes in digit replantation. It is simple to calculate preoperatively and aids in risk stratification, perioperative counseling, operative planning, and postoperative outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15589447251366678","type":"journal-article","created":{"date-parts":[[2025,9,18]],"date-time":"2025-09-18T09:04:54Z","timestamp":1758186294000},"page":"1416-1424","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["The Modified 5-Item Frailty Index Is a Predictor of Perioperative Complications in Digital Replantation"],"prefix":"10.1177","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3602-6387","authenticated-orcid":false,"given":"Thor S.","family":"Stead","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, New York-Presbyterian\/Weill Cornell Medical Center, New York City, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2496-9687","authenticated-orcid":false,"given":"Neel","family":"Vishwanath","sequence":"additional","affiliation":[{"name":"The Warren Alpert Medical School of Brown University, Providence, RI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikhil","family":"Sobti","sequence":"additional","affiliation":[{"name":"The Warren Alpert Medical School of Brown University, Providence, RI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tareq","family":"Kheirbek","sequence":"additional","affiliation":[{"name":"The Warren Alpert Medical School of Brown University, Providence, RI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy C.","family":"Kite","sequence":"additional","affiliation":[{"name":"The Warren Alpert Medical School of Brown University, Providence, RI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,9,18]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2021.04.004"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhsa.2011.01.031"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0020-1383(99)00196-5"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e318180ed61"},{"issue":"102","key":"e_1_3_2_6_2","first-page":"1","article-title":"Ambulatory surgery data from hospitals and ambulatory surgery centers: United States, 2010","volume":"2017","author":"Hall MJ","unstructured":"Hall MJ, Schwartzman A, Zhang J, et al. 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