Evidence map›Paper›PMID 41928719›Full record

ArticleThe Laryngoscope2026

Otologic Surgery Risk Prediction: Risk Analysis Index-Administrative Versus Modified Frailty Index-5.

Akshay Warrier, Nicole Kim, Ryan Bartholomew, Liliya Benchetrit, Daniel J Lee

Abstract readComparative Study
In one paragraph

Article in The Laryngoscope, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

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

5 authors.

Akshay WarrierDepartment of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA.ORCID https://orcid.org/0000-0003-4841-6366
Nicole KimDepartment of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, USA.
Ryan BartholomewDepartment of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, USA.ORCID https://orcid.org/0000-0002-8310-3544
Liliya BenchetritDepartment of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, USA.
Daniel J LeeDepartment of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesFrailty indices, including the modified frailty index (mFI-5) and the risk analysis index-administrative (RAI-A), are increasingly used to stratify surgical risk; however, their comparative utility in otology/neurotology remains understudied. This study compares the predictive performance of RAI-A versus mFI-5 for postoperative outcomes in a large otologic and lateral skull base cohort.

methodsA retrospective analysis of 2862 otologic surgery patients was performed. Primary outcomes included 30-day mortality, Clavien-Dindo (CD) complications, surgical site infection (SSI), nonhome discharge, and extended length of stay (eLOS). Frailty was assessed using validated indices, and predictive performance was evaluated using multivariate logistic regression and ROC curves.

resultsAcross the full cohort, RAI-A demonstrated superior discrimination (C-statistic) compared to mFI-5 for mortality (0.809 vs. 0.722, p = 0.021), CD II complications (0.793 vs. 0.788, p = 0.048), and SSI (0.721 vs. 0.712, p = 0.047). On multivariable analysis, RAI-A was significantly associated with CD II (OR 7.545; CI 2.367-24.048), CD IIIb (OR 17.925; CI 1.641-195.753), and eLOS (OR 40.623; CI 4.966-336.395). In the skull base subset, RAI-A was associated with higher odds of mortality (OR 14.47, 95% CI 3.02-69.31), serious complications (CD IV; OR 3.56, 95% CI 1.36-9.31), and nonhome discharge (OR 18.20, 95% CI 6.35-52.17).

conclusionRAI-A outperforms mFI-5 in predicting postoperative outcomes in otologic surgery, with similar findings for high-risk lateral skull base cases. These findings support incorporating RAI-based frailty assessment into preoperative planning to improve risk stratification and patient counseling. LEVEL OF EVIDENCE: 3:

Indexed as

FrailtyOtologic Surgical ProceduresPostoperative ComplicationsAgedAged, 80 and overFemaleHumansLength of StayMaleMiddle AgedPredictive Value of TestsRetrospective StudiesRisk AssessmentRisk Factorsfrailtymodified frailty indexotologic surgerypostoperative outcomesrisk analysis index

Identifiers

PMID41928719
PMCPMC13460496

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.