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Scientific Oral Presentation

Laryngology/Broncho-Esophagology

Modified 5-item Frailty Index as a Predictor of Postoperative Outcomes in Open Laryngeal Surgeries

Tuesday, October 20, 2026
8:12 AM - 8:18 AM PT
Location: 406B

    Presenting Author(s)

  • Erin M. Go, BA

    Medical Student
    Rutgers New Jersey Medical School
    Newark, NJ, United States

    • Co-Author(s)

  • Emma R. Thompson, BA

    Medical Student
    Rutgers New Jersey Medical School
    Jersey City, New Jersey, United States

  • Hetal K. Lad, BS

    Ms.
    Rutgers New Jersey Medical School
    Newark, New Jersey, United States

    • Senior Author(s)

  • KY

    Kenneth Yan, MD, PhD

    Assistant Professor
    Rutgers New Jersey Medical School
    Newark, NJ, United States

Disclosure(s):
Erin M. Go, BA:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Kenneth Yan, MD, PhD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Frailty is a well-validated predictor of adverse health outcomes in other otolaryngologic surgeries, but its utility in laryngeal surgeries is poorly characterized. This study investigates the association between Modified 5-Item Frailty Index (mFI-5) and postoperative outcomes following open laryngeal surgeries.

Methods: This retrospective cohort study identified 2,590 total cases of open laryngeal surgeries, including laryngectomy, laryngoplasty, tracheoplasty, and tracheal resection, performed between 01/2005-12/2020 from the American College of Surgeon’s National Surgical Quality Improvement Program. Patients were stratified by mFI-5 scores (0, 1, or ≥2). Baseline characteristics and postoperative outcomes were compared across frailty groups using Chi-squared or Fisher-Freeman-Halton exact tests when applicable. Multivariable logistic regression was used to adjust for age and ASA class, with significance at p< 0.05.

Results: Among 2,590 cases, there were 569 (22%) patients with mFI-5≥2, 1,011 (39%) with mFI-5=1, and 1,010 (39%) with mFI-5=0. Patients with mFI-5 scores of ≥2, 1, and 0 had mean lengths of stay of 12.9 ± 10.1 days, 12.2 ± 11.2 days, and 11.4 ± 10.0 days, respectively (p=0.019). Patients with mFI-5≥2 experienced significantly higher rates of mortality (19% vs. 13% vs. 13%, p< 0.008), increased likelihood of discharge to non-home facilities (23.2% vs. 14.6% vs. 12.4%, p< 0.001), and greater incidence of medical (15.3% vs.13.7% vs. 9.1%, p< 0.001) and overall (27.4% vs. 24.3% vs. 19.5%, p< 0.001) complications. Reoperation rates increased with mFI-5 scores but were not significant (15.9% vs. 13.8% vs. 12.5%, p=0.11). Total operative time did not differ significantly by frailty category (p=0.11).

Conclusions: Among patients receiving open laryngeal surgery, higher frailty scores were associated with non-home discharge, longer hospital stays, increased rates of mortality, and greater incidence of medical and overall postoperative complications, independent of age and ASA class. MFI-5 use in preoperative evaluations can support risk stratification and shared decision-making.