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Evaluating the predictive value of the modified frailty index (mFI-5) on postoperative outcomes in patients with high-grade gliomas
Journal article   Peer reviewed

Evaluating the predictive value of the modified frailty index (mFI-5) on postoperative outcomes in patients with high-grade gliomas

Peter G Zaki, Abigail McKenna, Sanjeev Herr, Lana Al Doori, Abigail Murtha, Davin Evanson, Jakob Nypaver, Nisha L Busch, Ramee Beool, Trent Kite, …
Journal of clinical neuroscience, v 150, 112018
16 Apr 2026
DOI: https://doi.org/10.1016/j.jocn.2026.112018
PMID: 41996937

Abstract

Surgical outcomes Frailty High-grade glioma Modified frailty index Glioblastoma Neurosurgery
High-grade gliomas (HGGs) are aggressive brain tumors associated with significant morbidity. This study aims to assess the utility of the 5-factor Modified Frailty Index (mFI-5) in predicting postoperative outcomes in patients undergoing surgical resection for HGGs. A retrospective analysis was conducted on a single institutional cohort of 196 patients surgically treated for glioblastoma January 2016 to January 2023. Patients were stratified by preoperative mFI-5 scores: prefrail (<2), frail (=2), and severely frail (>2). The primary outcomes included 30-day, 90-day,1-year overall survival, and progression-free survival (PFS). Secondary outcomes included hospital length of stay, 30-day readmission rates, and discharge status. Univariable and multivariable analyses were performed on these outcomes. Frailty was significantly associated with adverse outcomes. The median PFS was 9.2, 6.9, and 3.5 months for prefrail, frail, and severely frail patients respectively (p = 0.01). The 90-day overall survival rates were 89%, 91%, and 75% for these groups (p = 0.03). Frailty was not a significant predictor of 12-month survival (64%, 70%, and 58%; p = 0.72). Median survival was 17.9, 15.4, and 15.3 months, respectively (p = 0.02). Severely frail patients demonstrated lower rates of symptomatic resolution (66%, 53%, and 33%, respectively; p = 0.005), increased non-home discharge rates (24%, 55.9%, and 75%, respectively; p < 0.001), and higher rates of mRS > 2 upon discharge (5%, 26%, and 66%, respectively; p < 0.001). The mFI-5 effectively predicts postoperative outcomes and short-term survival in patients with HGGs. Integrating frailty assessments into preoperative evaluations may guide surgical decision-making and optimize post-operative management.

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