Journal of Medicine and Palliative Care · Feb 20, 2026
Predictive value of Modified Frailty Index for early mortality in hip and knee arthroplasty patients admitted to intensive care unit
By Kocaoglu M, Yılmaz H, Baltacı Ç et al.
Aims: With the expanding volume of hip and knee arthroplasty procedures, a growing proportion of patients present with comorbid conditions that may elevate their susceptibility to postoperative complications. The aim of this study was to investigate the relationship between preoperative frailty and early postoperative mortality (defined as death occurring during the ICU stay or within 7 days after surgery) in patients requiring ICU admission following hip or knee arthroplasty. Methods: This is a retrospective, exploratory study involving patients who underwent hip and knee arthroplasty at a single center between October 2023 and October 2024 and subsequently required intensive care unit admission during their first hospital stay. The 11-item Modified Frailty Index (mFI) was calculated from medical records, and a score of ≥0.36 was defined as frailty. Results: Of the 53 arthroplasty patients admitted to the ICU (mean age 76.4±9.7 years), early postoperative mortality occurred in 8 individuals (15.1%). Frailty was strongly associated with mortality, with rates of 38.9% in frail patients versus 2.9% in non-frail patients (p=0.0013), corresponding to an odds ratio of 21.64 and a relative risk of 13.4. Individuals who experienced mortality demonstrated significantly higher comorbidity counts and mFI values (both p=0.007), whereas age, sex, and surgical category showed no significant associations. Although revision procedures exhibited numerically higher mortality rates, this difference did not reach statistical significance (p=0.528).Conclusion: Frailty (mFI≥0.36) emerged as a strong predictor of early postoperative mortality within 7 days after surgery in ICU-admitted arthroplasty patients, exceeding the associations observed for age, sex, and surgical category. Incorporating frailty assessment into routine preoperative evaluations could help to identify high-risk individuals and guide perioperative optimization.