Evaluation of the Relationship Between Short and Medium Term Outcomes Using Two Different Frailty Indices in Complex Head and Neck Surgery

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Background: Comprehensive pre-anesthetic evaluation is known to play a crucial role in predicting morbidity and mortality in the perioperative and postoperative periods. Frailty is a condition characterized by reduced physiological reserve and resistance to stressors. It results from the accumulation of deficits in multiple organ systems, leading to physiological decline and subsequent changes in pharmacodynamics and pharmacokinetics. In this study, we aimed to evaluate the frailty scores of patients who underwent head and neck surgery. Material and Methods: This retrospective study included patients who underwent head and neck surgery in the otolaryngology operating rooms of Ankara City Hospital over a 2-year period. The mFI-5 (Modified 5-item Frailty Index) and CFS (Clinical Frailty Scale) were used for assessment. Results: A total of 54 patients were included in the study, with an average age of 57.9 ± 14.4 years. The proportion of patients who underwent neck dissection was 51.9%. A moderate correlation was found between the length of hospital stay and the mFI-5 and CFS scores. Similarly, patients who developed postoperative complications and those readmitted within 30 days had higher mFI-5 and CFS scores. While the mFI-5, CFS, and ASA scores showed similar trends, ASA was not statistically significant in predicting postoperative outcomes. Due to the low number of cases and deceased patients, the relationship with mortality could not be determined. Conclusions: Frailty is characterized by increased vulnerability and reduced reserve. As the population ages and life expectancy continues to rise, doctors and patients will increasingly face difficult decisions regarding treatment. This is particularly true for oncological surgery patients. Identifying patients as frail or high-risk can directly impact treatment decisions. The mFI-5 and CFS can be simple and useful tools for predicting perioperative outcomes in early and mid-term head and neck surgery.

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