Panayi AC, Haug V, Kauke-Navarro M, et al. - Since the modified frailty index 5 (mFI-5)—a scale based on the five variables diabetes, hypertension, COPD, congestive heart failure, and functional dependency—has been shown to be a valid predictor of surgical outcomes, researchers sought to assess the ability of the mFI-5 to anticipate the postoperative outcomes of head and neck microvascular reconstruction. A search of the American College of Surgeons' National Surgical Quality Improvement Program database from 2015 to 2019 yielded 5,323 cases of microvascular reconstruction, 3,795 of which were head and neck cases that provided the parameters needed to calculate the mFI-5. Increases in the mFI were linked to longer hospitalization periods higher rates of mortality, reoperation, and unplanned readmission. In microvascular head and neck reconstruction, the mFI-5 is a significant predictor of risk. Subgroup analysis by age reveals that the tool can assist in identifying younger patients who are frail and thus at risk. Surgeons can modify their operative and discharge planning, as well as post-operative support if frail patients are identified appropriately prior to surgery.