Objective: The aim of this study was to investigate the association between five modified frailty index (5-mFI) and outcomes after benign total hysterectomy with bilateral fallopian tubes and oophorectomy, and to explore its application in clinical prediction and intervention strategies.
Methods: The clinical data of patients who underwent benign total hysterectomy with bilateral fallopian tubes and oophorectomy in my hospital from January 2018 to December 2022 were retrospectively analyzed. A total of 438 cases meeting the criteria were included, and the general data, operation conditions and postoperative outcomes of the three different groups were compared according to frailty score. Statistical analysis methods including Chi-square test, correlation analysis, Logistic regression and multiple linear regression analysis were used to reveal the association between 5-mFI and these factors.
Results: There were significant differences between age, BMI, operation time, intraoperative blood loss, postoperative hospital stay and total cost and frailty score (p < 0.05). Patients with higher frailty scores had poorer postoperative outcomes, longer hospital stays and higher costs. However, there was no significant association between surgical method and frailty score (p > 0.05), and no significant difference in indications of hysterectomy among different frailty groups (p > 0.05).
Conclusions: The results of this study suggest that the modified frailty index is an effective tool for predicting outcomes after total hysterectomy. For patients with high expected frailty score, risk assessment and appropriate preoperative preparation should be carried out in advance to improve postoperative outcomes.
Key word: five modified frailty index, benign total hysterectomy, postoperative outcomes

Tong Zhao has completed his MD at the age of 29 years from FU DAN University, he has been engaged in clinical and research work of Ob&Gyn in Shanghai  Tong ji Medical Group Ting lin Hospital for more than 18 years, especially good at a variety of minimally invasive  gynecological surgery and examination, he’s one of the early gynecologists who can have total laporoscopic hysterectomy in his hospital, and published more than 10 papers in domestic  and  foreign  magazines!