Effects of Oral Frailty Index‐8 Score on Complications After Major Orthopaedic Surgery: A Single‐Center Retrospective Study

BACKGROUND: Oral frailty is defined as age-related oral function decline; however, its effect on surgical patients remains unclear. OBJECTIVE: This study aimed to evaluate the effect of oral frailty index-8 (OFI-8) on postoperative complications. METHODS: This retrospective study included patients aged ≥ 65 years who underwent elective total knee arthroplasty, total hip arthroplasty, or spinal surgery under general anaesthesia. Oral frailty was assessed using the OFI-8, with a total score ranging from 0 to 11, and patients with an OFI-8 score ≥ 4 were categorised as positive for oral frailty. The co-primary outcomes were the incidence of postoperative complications, defined as Clavien-Dindo classification (CDC) grade ≥ II complications, and the Comprehensive Complication Index (CCI) score. The association between a positive result for oral frailty and co-primary outcomes was evaluated using multiple logistic or multiple regression analyses adjusted for clinically relevant factors. RESULTS: Of the 608 patients included in the final analysis, 314 (51.6%) had OFI-8 scores ≥ 4. The overall incidence of complications with CDC grade ≥ II was 15%, with a mean CCI score of 15.6. After adjustment, an OFI-8 score of ≥ 4 was associated with an increased risk of CDC grade ≥ II complications (odds ratio, 1.65; 95% confidence interval, 1.19-2.42, p = 0.01) and an increased CCI (regression coefficients, 1.7; 95% confidence interval, 0.22-3.2, p = 0.02). CONCLUSION: The study findings suggest that an OFI-8 score of ≥ 4 is associated with the incidence and severity of postoperative complications.