Evidence map›Paper›PMID 39305322›Full record

ArticleLangenbeck's archives of surgery2024

Modified 5-Item Frailty Index (mFI-5) may predict postoperative outcomes after pancreatoduodenectomy for pancreatic Cancer.

Abdullah Khalid, Shamsher A Pasha, Lyudmyla Demyan, Oliver Standring, Elliot Newman, Daniel A King, Danielle DePeralta, Sepideh Gholami, Matthew J Weiss, Marcovalerio Melis

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Article in Langenbeck's archives of surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 1 pooled it
–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

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3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Clinical vulnerability to chemotherapy in cholangiocarcinoma: impact of nutritional status, frailty, and systemic inflammation.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026
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4 · The record

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5 · Who and what money

Authors and funding

10 authors.

Abdullah KhalidNorth Shore/Long Island Jewish General Surgery, Northwell Health, 300 Community Dr. Manhasset, Manhasset, NY, USA. akhalid7@northwell.edu.
Shamsher A PashaDepartment of Surgery, UT Health San Antonio, San Antonio, TX, USA.
Lyudmyla DemyanNorth Shore/Long Island Jewish General Surgery, Northwell Health, 300 Community Dr. Manhasset, Manhasset, NY, USA.
Oliver StandringNorth Shore/Long Island Jewish General Surgery, Northwell Health, 300 Community Dr. Manhasset, Manhasset, NY, USA.
Elliot NewmanNorthwell Health Lenox Hill Hospital, 100 E 77th St, New York, NY, USA.
Daniel A KingNorthwell Health Cancer Institute, 1111 Marcus Ave, New Hyde Park, NY, USA.
Danielle DePeraltaNorthwell Health Cancer Institute, 1111 Marcus Ave, New Hyde Park, NY, USA.
Sepideh GholamiNorthwell Health Cancer Institute, 1111 Marcus Ave, New Hyde Park, NY, USA.
Matthew J WeissNorthwell Health Cancer Institute, 1111 Marcus Ave, New Hyde Park, NY, USA.
Marcovalerio MelisNorthwell Health Lenox Hill Hospital, 100 E 77th St, New York, NY, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPancreatic Ductal Adenocarcinoma (PDAC) primarily affects older individuals with diminished physiological reserves. The Modified 5-Item Frailty Index (mFI-5) is a novel risk stratification tool proposed to predict postoperative morbidity and mortality. This study aimed to validate the mFI-5 for predicting surgical outcomes in patients undergoing pancreatoduodenectomy (PD) for PDAC.

methodsOur retrospective PDAC database included patients who underwent PD between 2014 and 2023. Patients were stratified by mFI-5 scores (0 best - 5 worst), which assess preoperative CHF, diabetes mellitus, history of COPD or pneumonia, functional health status, and hypertension requiring medication. Associations between mFI-5 scores and outcomes, including postoperative complications and mortality, were analyzed using logistic regression, Cox proportional hazards models, and Kaplan-Meier survival analysis.

resultsAmong 250 PDAC patients undergoing PD, 142 (56.8%) had mFI-5 scores ≤ 1, and 25 (10%) had scores ≥ 3. No patients had scores > 4. Higher mFI-5 scores correlated with older age (p < 0.001) and tobacco use (p = 0.036). Multivariate analysis identified age (RR 1.02, p = 0.038), ASA class (ASA III; RR 2.61, p < 0.001; ASA IV; RR 2.63, p = 0.026), and moderate alcohol consumption (RR 0.56, p = 0.038) as frailty predictors. An mFI-5 score > 2 independently associated with higher mortality (HR 2.08, p = 0.026). Median overall survival was significantly lower for patients with mFI-5 scores > 2 than for those with scores ≤ 2 (21.3 vs. 42.1 months, p = 0.022).

conclusionsThe mFI-5 is a valuable tool for predicting postoperative morbidity and mortality in PDAC patients undergoing PD. Integrating frailty assessment into preoperative evaluations can enhance patient selection and surgical outcomes. Future research should focus on incorporating frailty assessments into surgical planning and patient management to improve outcomes in this vulnerable population.

Indexed as

Carcinoma, Pancreatic DuctalFrailtyPancreatic NeoplasmsPancreaticoduodenectomyPostoperative ComplicationsAgedAged, 80 and overFemaleHumansMaleMiddle AgedPredictive Value of TestsRetrospective StudiesRisk AssessmentFrailty indexPancreatic ductal adenocarcinomaPancreatoduodenectomyPostoperative outcomesRisk stratification

Identifiers

PMID39305322

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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.