The Particulars: In most cases, eligibility for hip and knee replacement surgery has been based largely upon the patient’s biological age. Recent research suggests, however, that a patient’s level of frailty may be a reliable independent risk factor for adverse health outcomes.

Data Breakdown: Researchers in Detroit created and implemented a simplified frailty index to stratify risks for mortality and morbidity in more than 40,000 hip and knee replacement patients. Based on 11 data points collected by the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database, the index included items that can easily be obtained by taking a simple medical history. Patients with high frailty scores had significantly higher mortality and serious postoperative complication rates when compared with those with low frailty scores. The frailty index was a more reliable predictor of mortality and serious complications than patient age.

Take Home Pearl: A simple frailty index that is mapped to the ACS NSQIP database appears to be more reliable than patient age in predicting adverse outcomes among patients considering joint replacement.