Berkay KÜÇÜK, Osman Yağız ATLI
Journal of Medicine and Palliative Care - 2026;7(4):804-812
Aims: Proximal femur fractures pose a major problem for geriatric patients due to both their increasing incidence and their adverse postoperative outcomes. Based on this, we aimed to demonstrate the prognostic value of the 5-factor modified frailty index (mFI-5) in patients with proximal femur fractures who were monitored in the postoperative intensive care unit (ICU) and to evaluate its relationship with clinical outcomes. Methods: This retrospective cohort study included 246 patients between August 2023 and February 2026. Demographic data, laboratory and clinical outcomes, and ICU and 90-day mortality rates were recorded. Receiver operating characteristic (ROC) curve analysis and logistic regression analysis were performed to assess the prognostic value of the mFI-5. Results: Twenty-seven patients (10.98%) died in the ICU. In patients with an mFI-5 score of >=2, the need for vasopressors, invasive mechanical ventilation, and postoperative sepsis was significantly higher (p=0.008, p=0.01, and p=0.037, respectively). In addition, ICU mortality was also higher in this group (p=0.008). Upon examination of ROC curve analyses, the AUC value for mFI-5 was 0.706, and the cutoff value was 2 (p<0.001). In the multivariate logistic regression analysis, mFI-5 was also a strong independent risk factor for ICU mortality, with an odds ratio (OR) of 1.760 and p=0.033. Conclusion: The mFI-5 demonstrated an independent prognostic effect regarding poor clinical outcomes and mortality. Considering frailty indices in postoperative patients may offer opportunities for the early identification of critically ill patients and the prevention of complications.
