Risk Analysis Index Versus Modified Frailty Index: Outcomes After Otolaryngologic Surgery

Authors

• Lauran K. Evans, David Geffen School of Medicine at UCLA
• Carine Tamamian, UC San Diego School of Medicine
• Desiree Delavary, School of Osteopathic Medicine in Arizona
• Matthew E. Lin, David Geffen School of Medicine at UCLA
• Hong Ho Yang, Stanford University
• Maie St. John, David Geffen School of Medicine at UCLA
• Dinesh K. Chhetri, David Geffen School of Medicine at UCLA

Document Type

Article

Publication Title

Laryngoscope

Abstract

Objective: Patient frailty negatively impacts postsurgical outcomes across multiple specialties. Commonly used frailty scoring systems include the Modified 5-Item Frailty Index (MFI-5) and the Clinical Risk Analysis Index (RAI-C). We compared these frailty indices in predicting postsurgical outcomes in otolaryngology, a comparison that has never been completed to date. Methods: Retrospective chart review of patients undergoing otolaryngologic surgery at a quaternary care medical center (2022–2024) with an RAI-C score available for analysis. Chi-square analysis and ROC curves were utilized to determine associations and predictive ability of each scoring system. Results: Among 1209 patients, 21% met MFI-5 frailty criteria (MFI-5 score > 1), and 23% met RAI-C frailty criteria (RAI-C score > 30). The Pearson correlation coefficient between MFI-5 and RAI-C was 0.481 (95% CI [0.43, 0.53]), indicating a moderate correlation between the two metrics. Patients deemed frail by RAI-C had 5.7 times higher odds of experiencing a postoperative complication than non-frail counterparts (95% CI [3.51, 9.28], p < 0.0001), but MFI-5 frailty status was not associated with postoperative complications. Both RAI-C and MFI-5 demonstrated significant predictive ability for 30-day readmission (AUC 0.77, 95% CI [0.64, 0.89] vs. AUC 0.76, 95% CI [0.61, 0.88]), respectively. When compared to MFI-5, RAI-C had greater predictive performance for all other postoperative outcomes in this study. Conclusion: RAI-C outperformed MFI-5 in predicting postoperative outcomes in patients undergoing otolaryngologic surgeries. RAI-C assessment should be considered in frailty research, multidisciplinary treatment planning, and managing patient expectations and outcomes.

First Page

4655

Last Page

4663

DOI

10.1002/lary.32408

Publication Date

12-1-2025

Recommended Citation

Evans, Lauran K.; Tamamian, Carine; Delavary, Desiree; Lin, Matthew E.; Yang, Hong Ho; St. John, Maie; and Chhetri, Dinesh K., "Risk Analysis Index Versus Modified Frailty Index: Outcomes After Otolaryngologic Surgery" (2025). SOMA Student Publications. 17.
https://scholarworks.atsu.edu/soma-student/17