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. 2025 Jul;17(3):267-273.
doi: 10.1177/17585732241229215. Epub 2024 Jan 31.

Higher modified frailty index score is associated with 30-day postoperative complications following revision total shoulder arthroplasty

Bruce Tanner Seibold  1 , Theodore Quan  1 , Amy Y Zhao  1 , Philip M Parel  1 , Jacob D Mikula  2 , Frederick Mun  2 , Umasuthan Srikumaran  2 , Zachary R Zimmer  1
Affiliations

Higher modified frailty index score is associated with 30-day postoperative complications following revision total shoulder arthroplasty

Bruce Tanner Seibold et al. Shoulder Elbow. 2025 Jul.

Abstract

Background: Previous studies have shown that increased 5-item modified frailty index (mFI-5) scores are associated with poor surgical outcomes. This study seeks to determine whether the comorbidities comprising the mFI-5 were correlated with poor outcomes following revision total shoulder arthroplasty (TSA).

Methods: Utilizing the National Surgical Quality Improvement Program database, a mFI-5 score was calculated for all patients 50 years and older who underwent revision TSA between 2013 and 2019. Pearson's Chi-squared tests and multivariable regression analysis were used to evaluate the association of the mFI score with various postoperative complications.

Results: Patients with a mFI-5 score of 2+ had significantly increased risk of readmission (OR 2.58), bleeding requiring transfusion (OR 3.66), extended length of stay (OR 2.43), and discharge to a non-home destination (OR 3.22) compared to patients with a mFI-5 score of 0. Relative to patients with a score of 1, those with a mFI-5 score of 2+ had an increased risk of postoperative transfusion (OR 2.46), extended length of stay (OR 2.16), and discharge to a non-home location (OR 2.84).

Discussion: The mFI-5 is a valuable tool that can stratify patients based on risk for postoperative complications following revision TSA.

Keywords: complications; etiology; frailty; modified frailty index; revision total shoulder arthroplasty.

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Conflict of interest statement

BTS, TQ, AYZ, and PMP wrote the first draft of the manuscript. All authors reviewed and edited the manuscript and approved the final version of the manuscript. The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

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