Adaptation of the Frailty Index for Brazilian Portuguese in Adult Spine Deformity Surgery

Abstract

Objectives To adapt the adult spinal deformity frailty index (ASD-FI), which was presented as an instrument for stratification of risk of surgical complications, for application in the Brazilian population. Methods This is a consensus-building study, following the Delphi method, in which a team of six Brazilian spine surgery specialists worked alongside the International Spine Study Group (ISSG), the group responsible for preparing the original version of the ASD-FI, in order to adapt the index for the Brazilian population. The variables to be included in the new version, as well as the translation of the terminology into Portuguese, were evaluated and a consensus was considered to have been reached when all (100%) of the Brazilian experts were in agreement. Results A version of the ASD-FI was created, composed of 42 variables, with the inclusion of two new variables that were not included in the original version. The new version was then back translated into English and approved by the ISSG members, resulting in the adapted version of the ASD-FI for the Brazilian population. Conclusion This study presents an adapted version of the adult spinal deformity frailty index for the Brazilian population, for the purpose of risk stratification in the surgical treatment of these complex deformities. Level of evidence II; Study of adaptation of a valid score.

Tradução e adaptação transcultural do questionário SOSG-OQ 2.0 para o português brasileiro

“…De maneira similar, em trabalho realizado pelo Brazilian Spine Study Group em conjunto com outros cirurgiões brasileiros, traduziu-se o Índice de Fragilidade (Frailty Index), 30 e, apesar da ocorrência discrepâncias entre alguns itens, poucas adaptações culturais foram necessárias. 31 O SOSG-OQ é composto por 27 questões, sendo 20 baseadas nos sintomas e impactos da doença na qualidade de vida, e sete questões sobre como o paciente se sente em relação ao procedimento cirúrgico. 20,21 Em estudos de avaliação psicométrica e de consistência, 21,24 o SOSG-OQ se mostrou fortemente correlacionado com a pontuação de qualidade de vida obtida no EQ-5D e no SF-36, e os seus subgrupos apresentaram forte consistência interna.…”

“…Similarly, in a study by the Brazilian Spine Study Group and Brazilian surgeons the Frailty Index 30 was translated; despite discrepancies regarding some items, few cross-cultural adaptations were required. 31 The SOSG-OQ consists of 27 questions, including 20 on the symptoms and impact of the disease on the patient's quality of life, plus 7 questions on how the patient feels about the surgical procedure. 20,21 In psychometric and consistency evaluation studies, 21,24 the SOSG-OQ correlated strongly with the quality-of-life scores on the EQ-5D and SF-36.…”

Why are frailty indices not used systematically during preoperative spine consultations?

“…Urrutia et al 11 in Chile and Pereira Duarte et al 12 in Argentina empirically documented the utility of the APGAR score and mFI, respectively, in current practice. In Brazil, Pratali et al 13 published a Portuguese-language adaptation of the ASD-FI endorsed by the International Spine Study Group (ISSG).…”