Evaluating the Use of 5-Factor Modified Frailty Index to Predict Wound-Healing Complications in Reduction Mammoplasty

BACKGROUND: Reduction mammoplasty is an established treatment for symptomatic macromastia. Understanding risk factors associated with complications is essential for counseling and patient selection. The modified frailty index (mFI-5) has been proposed as a simple tool to assess risk in surgical candidates. OBJECTIVES: The authors sought to determine whether the mFI-5 can accurately predict wound-healing complications following reduction mammoplasty. METHODS: A retrospective review was performed of primary bilateral reduction mammoplasty cases between 2017 and 2019 at 1 institution. mFI-5 scores were calculated for each patient. Thirty-day wound-healing complications were defined as incisional dehiscence, T-point breakdown, nipple-areolar complex necrosis, and fat necrosis. Univariate and multivariate logistic regression were used to evaluate predictive value. RESULTS: Four hundred and seventy-four patients were stratified into 3 age groups: 15 to 30, 31 to 50, and >51. Twenty-six percent of patients developed 1 wound-healing problem. On univariate analysis, ages 31 to 50 and 51+ (odds ratio [OR] = 2.75 and 3.16) and mFI score of 1 (OR = 2.07) were associated with an increased risk of wound-healing complications. Adjusted multivariate analysis indicated that age >51 years significantly predicted wound-healing issues (OR = 2.89; P = .001) when controlled for the American Society of Anesthesiologists (ASA) score, smoking, and BMI. The mFI-5 did not significantly predict wound-healing issues when controlled for age, ASA, BMI, or smoking. CONCLUSIONS: In the study population, the mFI-5 was not a statistically significant predictor of wound-healing complications following reduction mammoplasty. When controlling for confounders, advanced age alone seems to place patients at higher risk for wound-healing complications. LEVEL OF EVIDENCE: 3 (THERAPEUTIC): For image description, please refer to the figure legend and surrounding text.