The Impact of Modified Frailty Index-5 on Postoperative Outcomes and Survival in Patients Undergoing Pneumonectomy
Abstract
Background: Pneumonectomy is a major surgical procedure for central lung cancers but is associated with high morbidity and mortality. This study aimed to evaluate the association between the Modified Frailty Index-5 (mFI-5) score and major postoperative complications and overall survival in patients undergoing pneumonectomy.
Methods: Seventy-four patients who underwent pneumonectomy for non–small cell lung cancer were retrospectivelyreviewed. Patients undergoing pneumonectomy for benign pathologies or non-NSCLC indications were excluded to maintain a homogeneous oncological cohort. The mFI-5 scores were calculated based on five parameters: diabetes, hypertension, heart failure, COPD, and functional dependence. Major complications were defined as Clavien–Dindo Grade ≥3. Independent prognostic factors were identified using multivariable logistic and Cox regression models.
Results: The mean age was 59.1 ± 10.6 years, and 85.1% were male. Major postoperative complications occurred in 28.4% of patients. In multivariable analysis, mFI-5 was not independently associated with major postoperative complications. However, higher mFI-5 scores were independently associated with reduced overall survival (HR = 1.428, p = 0.048). The development of postoperative complications was the sole independent determinant of both intensive care unit and hospital length of stay.
Conclusion: The mFI-5 score appears to be a practical and clinically accessible tool for preoperative risk stratification in pneumonectomy candidates. However, given the retrospective design and limited sample size, these findings should be interpreted with caution. mFI-5 may serve as a supportive parameter in identifying high-risk patients and guiding perioperative management strategies.
Keywords
Pneumonectomy, Modified Frailty Index-5, Postoperative Complications, Lung Cancer, Survival
Supporting Institution
This research received no external funding.
Project Number
None
Ethical Statement
This study was conducted in accordance with the Declaration of Helsinki. The study protocol was approved by the Institutional Review Board of Ankara Abdurrahman Yurtaslan Oncology Training and Research Hospital (Approval No:2025-06/96). The requirement for informed consent was waived due to the retrospective design of the study.
Thanks
Not applicable.
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