Abstract

Objective. To evaluate the utility of a modified frailty index as an indicator of postoperative mortality in patients undergoing tracheostomy. Study Design. Case series with chart review. Setting. Tertiary care veterans hospital. Subjects and Methods. A chart review was conducted of consecutive tracheostomies performed between April 2007 and September 2012. A modified frailty index consisting of 11 items based on the Revised Minimum Data Set Mortality Rating Index (MMRI-R) was retrospectively applied using the patient's status immediately prior to tracheostomy. The resultant 6-month calculated mortality risk was compared with both the Veterans Health Administration Surgical Quality Improvement Program's (VASQIP) 30-day calculated mortality and actual mortality. Results. One hundred consecutive tracheostomies were analyzed. No patients were excluded. Sixty-nine patients died within the study period, with 1-, 6-, and 12-month mortality rates of 25%, 43%, and 59%, respectively. The average calculated 6-month mortality risk using the modified frailty index was 40.5% for nonsurvivors compared with 25.4% for survivors (P = .001). Both the VASQIP calculator and modified frailty index differentiated mortality risks between patients without head and neck cancer who survived less than 6 months versus those who survived longer than 6 months (P = .006 and .01). However, neither the VASQIP nor the modified frailty index differentiated mortality risks for head and neck cancer patients who survived less than 6 months versus greater than 6 months (P = .94 and .26). Conclusion. A modified frailty index identifies patients without head and neck cancer at high risk of postoperative mortality after tracheostomy.

Original languageEnglish (US)
Pages (from-to)568-573
Number of pages6
JournalOtolaryngology - Head and Neck Surgery (United States)
Volume150
Issue number4
DOIs
StatePublished - Jan 1 2014

Fingerprint

Tracheostomy
Mortality
Veterans Health
United States Department of Veterans Affairs
Head and Neck Neoplasms
Quality Improvement
Veterans Hospitals
Tertiary Healthcare
Survivors

Keywords

  • VASQIP
  • frailty
  • mortality
  • risk calculator
  • tracheostomy

ASJC Scopus subject areas

  • Surgery
  • Otorhinolaryngology

Cite this

A frailty index identifies patients at high risk of mortality after tracheostomy. / Johnson, Matthew S.; Bailey, Travis L.; Schmid, Kendra K; Lydiatt, William M.; Johanning, Jason M.

In: Otolaryngology - Head and Neck Surgery (United States), Vol. 150, No. 4, 01.01.2014, p. 568-573.

Research output: Contribution to journalArticle

@article{e3ae14f161c74e99aed49ba58695b90d,
title = "A frailty index identifies patients at high risk of mortality after tracheostomy",
abstract = "Objective. To evaluate the utility of a modified frailty index as an indicator of postoperative mortality in patients undergoing tracheostomy. Study Design. Case series with chart review. Setting. Tertiary care veterans hospital. Subjects and Methods. A chart review was conducted of consecutive tracheostomies performed between April 2007 and September 2012. A modified frailty index consisting of 11 items based on the Revised Minimum Data Set Mortality Rating Index (MMRI-R) was retrospectively applied using the patient's status immediately prior to tracheostomy. The resultant 6-month calculated mortality risk was compared with both the Veterans Health Administration Surgical Quality Improvement Program's (VASQIP) 30-day calculated mortality and actual mortality. Results. One hundred consecutive tracheostomies were analyzed. No patients were excluded. Sixty-nine patients died within the study period, with 1-, 6-, and 12-month mortality rates of 25{\%}, 43{\%}, and 59{\%}, respectively. The average calculated 6-month mortality risk using the modified frailty index was 40.5{\%} for nonsurvivors compared with 25.4{\%} for survivors (P = .001). Both the VASQIP calculator and modified frailty index differentiated mortality risks between patients without head and neck cancer who survived less than 6 months versus those who survived longer than 6 months (P = .006 and .01). However, neither the VASQIP nor the modified frailty index differentiated mortality risks for head and neck cancer patients who survived less than 6 months versus greater than 6 months (P = .94 and .26). Conclusion. A modified frailty index identifies patients without head and neck cancer at high risk of postoperative mortality after tracheostomy.",
keywords = "VASQIP, frailty, mortality, risk calculator, tracheostomy",
author = "Johnson, {Matthew S.} and Bailey, {Travis L.} and Schmid, {Kendra K} and Lydiatt, {William M.} and Johanning, {Jason M}",
year = "2014",
month = "1",
day = "1",
doi = "10.1177/0194599813519749",
language = "English (US)",
volume = "150",
pages = "568--573",
journal = "Otolaryngology - Head and Neck Surgery (United States)",
issn = "0194-5998",
publisher = "Mosby Inc.",
number = "4",

}

TY - JOUR

T1 - A frailty index identifies patients at high risk of mortality after tracheostomy

AU - Johnson, Matthew S.

AU - Bailey, Travis L.

AU - Schmid, Kendra K

AU - Lydiatt, William M.

AU - Johanning, Jason M

PY - 2014/1/1

Y1 - 2014/1/1

N2 - Objective. To evaluate the utility of a modified frailty index as an indicator of postoperative mortality in patients undergoing tracheostomy. Study Design. Case series with chart review. Setting. Tertiary care veterans hospital. Subjects and Methods. A chart review was conducted of consecutive tracheostomies performed between April 2007 and September 2012. A modified frailty index consisting of 11 items based on the Revised Minimum Data Set Mortality Rating Index (MMRI-R) was retrospectively applied using the patient's status immediately prior to tracheostomy. The resultant 6-month calculated mortality risk was compared with both the Veterans Health Administration Surgical Quality Improvement Program's (VASQIP) 30-day calculated mortality and actual mortality. Results. One hundred consecutive tracheostomies were analyzed. No patients were excluded. Sixty-nine patients died within the study period, with 1-, 6-, and 12-month mortality rates of 25%, 43%, and 59%, respectively. The average calculated 6-month mortality risk using the modified frailty index was 40.5% for nonsurvivors compared with 25.4% for survivors (P = .001). Both the VASQIP calculator and modified frailty index differentiated mortality risks between patients without head and neck cancer who survived less than 6 months versus those who survived longer than 6 months (P = .006 and .01). However, neither the VASQIP nor the modified frailty index differentiated mortality risks for head and neck cancer patients who survived less than 6 months versus greater than 6 months (P = .94 and .26). Conclusion. A modified frailty index identifies patients without head and neck cancer at high risk of postoperative mortality after tracheostomy.

AB - Objective. To evaluate the utility of a modified frailty index as an indicator of postoperative mortality in patients undergoing tracheostomy. Study Design. Case series with chart review. Setting. Tertiary care veterans hospital. Subjects and Methods. A chart review was conducted of consecutive tracheostomies performed between April 2007 and September 2012. A modified frailty index consisting of 11 items based on the Revised Minimum Data Set Mortality Rating Index (MMRI-R) was retrospectively applied using the patient's status immediately prior to tracheostomy. The resultant 6-month calculated mortality risk was compared with both the Veterans Health Administration Surgical Quality Improvement Program's (VASQIP) 30-day calculated mortality and actual mortality. Results. One hundred consecutive tracheostomies were analyzed. No patients were excluded. Sixty-nine patients died within the study period, with 1-, 6-, and 12-month mortality rates of 25%, 43%, and 59%, respectively. The average calculated 6-month mortality risk using the modified frailty index was 40.5% for nonsurvivors compared with 25.4% for survivors (P = .001). Both the VASQIP calculator and modified frailty index differentiated mortality risks between patients without head and neck cancer who survived less than 6 months versus those who survived longer than 6 months (P = .006 and .01). However, neither the VASQIP nor the modified frailty index differentiated mortality risks for head and neck cancer patients who survived less than 6 months versus greater than 6 months (P = .94 and .26). Conclusion. A modified frailty index identifies patients without head and neck cancer at high risk of postoperative mortality after tracheostomy.

KW - VASQIP

KW - frailty

KW - mortality

KW - risk calculator

KW - tracheostomy

UR - http://www.scopus.com/inward/record.url?scp=84899104084&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84899104084&partnerID=8YFLogxK

U2 - 10.1177/0194599813519749

DO - 10.1177/0194599813519749

M3 - Article

VL - 150

SP - 568

EP - 573

JO - Otolaryngology - Head and Neck Surgery (United States)

JF - Otolaryngology - Head and Neck Surgery (United States)

SN - 0194-5998

IS - 4

ER -