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Beyond the standard preoperative evaluation: The impact of functional dependency on complications after thyroidectomy

      Functional dependency is defined as difficulty carrying out activities of daily living needed for self-care.
      • Fried L.P.
      • Ferrucci L.
      • Darer J.
      • Williamson J.D.
      • Anderson G.
      Untangling the concepts of disability, frailty, and comorbidity: implications for improved targeting and care.
      Unlike frailty, which is a “physiologic state of increased vulnerability to stressors that results from decreased physiologic reserves, and even dysregulation, of multiple physiologic systems,”
      • Fried L.P.
      • Ferrucci L.
      • Darer J.
      • Williamson J.D.
      • Anderson G.
      Untangling the concepts of disability, frailty, and comorbidity: implications for improved targeting and care.
      dependency is easier to measure and thus can act as a surrogate to measure perioperative outcomes.
      • Clifton J.C.
      • Engoren M.
      • Shotwell M.S.
      • et al.
      The impact of functional dependence and related surgical complications on postoperative mortality.
      Similar to frailty, functional dependence is an established risk factor for post-surgical complications. In this issue of American Journal of Surgery, Mounsey et al. provided a retrospective analysis of the National Surgical Quality Improvement Program (NSQIP) database to examine the association between dependent status and complications after thyroid surgery.
      • Mounsey M.
      • Gillis A.
      • Ata A.
      • Stain S.
      • Tafen M.
      Dependent status is a risk factor for complications after thyroidectomy.
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      References

        • Fried L.P.
        • Ferrucci L.
        • Darer J.
        • Williamson J.D.
        • Anderson G.
        Untangling the concepts of disability, frailty, and comorbidity: implications for improved targeting and care.
        J Gerontol Biol Med Sci. 2004 Mar; 59: 255-263https://doi.org/10.1093/gerona/59.3.m255.PMID:15031310
        • Clifton J.C.
        • Engoren M.
        • Shotwell M.S.
        • et al.
        The impact of functional dependence and related surgical complications on postoperative mortality.
        J Med Syst. 2021 Nov 25; 46: 6https://doi.org/10.1007/s10916-021-01779-8.PMID:34822038;PMCID:PMC8709534
        • Mounsey M.
        • Gillis A.
        • Ata A.
        • Stain S.
        • Tafen M.
        Dependent status is a risk factor for complications after thyroidectomy.
        Am J Surg. 2022; 224: 1034-1037https://doi.org/10.1016/j.amjsurg.2022.05.035
        • Scarborough J.E.
        • Bennett K.M.
        • Englum B.R.
        • Pappas T.N.
        • Lagoo-Deenadayalan S.A.
        The impact of functional dependency on outcomes after complex general and vascular surgery.
        Ann Surg. 2015 Mar; 261 (PMCID: PMC4346574): 432-437https://doi.org/10.1097/SLA.0000000000000767.PMID:24887971
        • Chen S.Y.
        • Stem M.
        • Gearhart S.L.
        • Safar B.
        • Fang S.H.
        • Efron J.E.
        Functional dependence versus frailty in gastrointestinal surgery: are they comparable in predicting short-term outcomes?.
        Surgery. 2018 Dec; 164: 1316-1324https://doi.org/10.1016/j.surg.2018.06.007.Epub2018Jul31.PMID:30076028
        • Valkenet K.
        • van de Port I.G.
        • Dronkers J.J.
        • de Vries W.R.
        • Lindeman E.
        • Backx F.J.
        The effects of preoperative exercise therapy on postoperative outcome: a systematic review.
        Clin Rehabil. 2011 Feb; 25 (PMID: 21059667): 99-111https://doi.org/10.1177/0269215510380830.Epub2010Nov8
        • Twomey R.
        • Culos-Reed S.N.
        • Dort J.C.
        Exercise prehabilitation-supporting recovery from major head and neck cancer surgery.
        JAMA Otolaryngol Head Neck Surg. 2020 Aug 1; 146: 689-690https://doi.org/10.1001/jamaoto.2020.1346.PMID:32584379
        • Loewen I.
        • Jeffery C.C.
        • Rieger J.
        • Constantinescu G.
        Prehabilitation in head and neck cancer patients: a literature review.
        J Otolaryngol Head Neck Surg. 2021 Jan 6; 50: 2https://doi.org/10.1186/s40463-020-00486-7.PMID:33407922;PMCID:PMC7789666
        • Taye A.
        • Inabnet 3rd, W.B.
        • Pan S.
        • et al.
        Post-thyroidectomy emergency room visits and readmissions: assessment from the collaborative endocrine surgery quality improvement program (CESQIP).
        Am J Surg. 2020 Oct; 220 (Epub 2020 Feb 19. PMID: 32115176): 813-820https://doi.org/10.1016/j.amjsurg.2020.02.036
        • Zreik J.
        • Alvi M.A.
        • Yolcu Y.U.
        • Sebastian A.S.
        • Freedman B.A.
        • Bydon M.
        Utility of the 5-item modified frailty index for predicting adverse outcomes following elective anterior cervical discectomy and fusion.
        World Neurosurg. 2021 Feb; 146 (Epub 2020 Nov 3. PMID: 33152490): e670-e677https://doi.org/10.1016/j.wneu.2020.10.154