Evidence map›Paper›PMID 38874611›Full record

ArticleSurgical endoscopy2024

Evaluating frailty using the modified frailty index for colonic diverticular disease surgery: analysis of the national inpatient sample 2015-2019.

Tyler McKechnie, Ghazal Jessani, Noor Bakir, Yung Lee, Niv Sne, Aristithes Doumouras, Dennis Hong, Cagla Eskicioglu

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Article in Surgical endoscopy, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Early post-operative outcomes in adults undergoing minimally invasive versus open emergency colorectal surgery: A retrospective cohort study of the ACS-NSQIP 2016-2022.Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2026
    Article
  3. Article
4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Tyler McKechnie *Division of General Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada.
Ghazal Jessani *Michael G. DeGroote School of Medicine, McMaster University, 50 Charlton Avenue East, Hamilton, ON, L8N 4A6, Canada.
Noor BakirDivision of General Surgery, Department of Surgery, University of Toronto, Toronto, ON, Canada.
Yung LeeDivision of General Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada.
Niv SneDivision of General Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada.
Aristithes DoumourasDivision of General Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada.
Dennis HongDivision of General Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada.
Cagla EskiciogluDivision of General Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada. eskicio@mcmaster.ca.ORCID 0000-0003-3920-066X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundFrailty has been associated with increased postoperative mortality and morbidity; however, the use of the modified frailty index (mFI-11) to assess patients undergoing surgery for diverticular disease has not been widely assessed. This paper aims to examine frailty, evaluated by mFI-11, to assess postoperative morbidity and mortality among patients undergoing operative intervention for colonic diverticular disease.

methodsWe used data from the Healthcare Cost and Utilization Project National Inpatient Sample (October 1, 2015-December 31, 2019). ICD-10-CM codes were utilized to identify a cohort of adult patients with a primary admission diagnosis of diverticulitis. mFI-11 items were adapted to correspond with ICD-10-CM codes. Patients were stratified into robust (mFI < 0.27) and frail (mFI ≥ 0.27) groups. Primary outcomes were in-hospital postoperative morbidity and mortality. Secondary outcomes included system-specific postoperative complications, length of stay (LOS), total admission cost, and discharge disposition. Multivariable regression models were fit.

resultsOf the 26,826 patients, there were 24,194 patients with mFI-11 < 0.27 (i.e., robust) and 2,632 patients with mFI-11 ≥ 0.27 (i.e., frail). Adjusted analysis showed significant increases in postoperative mortality (aOR 2.16, 95% CI 1.38-3.38, p = 0.001) and overall postoperative morbidity (aOR 1.84, 95% CI 1.65-2.06, p < 0.001). LOS was higher in the frail group (MD 1.78 days, 95% CI 1.46-2.11, p < 0.001) as well as total cost (MD $25,495.19, 95% CI $19,851.63-$31,138.75, p < 0.001).

conclusionIn the elective setting, a high mFI-11 (i.e., presence of the variables comprising the index) could alert clinicians to the possibility of implementing preoperative optimization strategies. In the emergent setting, a high mFI-11 may help guide prognostication for these vulnerable patients.

Indexed as

Diverticulitis, ColonicFrailtyLength of StayPostoperative ComplicationsAdultAgedAged, 80 and overColectomyFemaleHospital MortalityHumansMaleMiddle AgedRetrospective StudiesUnited StatesColorectal cancerColorectal neoplasiaColorectal surgeryObesityPostoperative morbidity

Identifiers

PMID38874611

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.