The prognostic value of the 5-factor modified frailty index in patients with proximal femur fractures followed up in the postoperative intensive care unit: a retrospective cohort study

Abstract

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