External validation of the adult spinal deformity (ASD) frailty index (ASD-FI)

Miller, Emily; Vila-Casademunt, Alba; Neuman, Brian J.; Sciubba, Daniel M.; Kebaish, Khaled M.; Smith, Justin S.; Alanay, Ahmet; Acaroğlu, Emre; Kleinstück, Frank; Obeid, Ibrahim; Pérez-Grueso, Francisco Javier Sánchez; Carreon, Leah Y.; Schwab, Frank J.; Bess, Shay; Scheer, Justin K.; Lafage, Virginie; Shaffrey, Christopher I.; Pellisé, Ferràn; Ames, Christopher P.

doi:10.1007/s00586-018-5575-3

Cited by 54 publications

(60 citation statements)

References 21 publications

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“…A prolonged LOS and discharge to a new facility are both predicted by the mFI based on unadjusted and adjusted analyses. 9 Similarly, the mean hospital stay is 2.1 times longer for severely frail patients compared with patients who are not frail; 40 however, it has been reported that high frailty scores are not associated with a LOS > 5 days. 22 In addition, others have found that the discharge disposition and LOS did not correlate significantly with frailty.…”

Section: Discussionmentioning

confidence: 99%

“…9 In another study, the author used the ASD-FI to calculate frailty scores for 266 ASD patients; 51% were categorized as not frail, 34% as frail, 15% as severely frail, and the overall mean ASD-FI score was 0.29. 40 Passias et al 35 developed a simplified frailty index for cervical deformity patients; the mean CD-FI was 0.31±0.14. The breakdown of patients based on the CD-FI category was as follows: not frail, 47.9%; frail, 46.3%; and severely frail, 5.8%.…”

Section: Dovepressmentioning

confidence: 99%

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<p>Frailty and Post-Operative Outcomes in the Older Patients Undergoing Elective Posterior Thoracolumbar Fusion Surgery</p>

Sun¹,

Lu²,

Kong³

et al. 2020

CIA

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Background and Aim: Frailty is an independent predictor of mortality and adverse events (AEs) in patients undergoing surgery. This study aimed to quantify the ability of Modified Frailty Index (mFI) to predict AEs in older patients undergoing elective posterior thoracolumbar fusion surgery. Methods: We retrospectively reviewed the results of 426 patients with the following diagnoses and follow-up evaluations of at least 12 months duration: lumbar disc herniation, 125; degenerative spondylolisthesis, 81; lumbar spinal canal stenosis, 187; and adult spinal deformities, 33. The cases were divided into two groups. The long spinal fusion (LSF) group was defined as ≥3 spinal levels with segmental pedicle-screw fixation. Short spinal fusion (SSF) were defined with at most two levels. The mFI used in the present study is an 11variable assessment. The association of frailty with AEs was determined after adjusting for known and suspected confounders. Results: Frailty was presented in 66 patients (15.5%) within the total population (LSF, 21.9% and SSF, 11.8%). Rates of AEs assessed in the study increased stepwise with an increase in the mFI for the two groups. The severity of frailty was an independent predictor of any, major, and minor complications in the LSF group and any, minor complication in the SSF group (P<0.05). A comparison of post-operative clinical outcomes showed that the ODI and SF-36 scores deteriorated as the mFI increased. Conclusion: Frailty was shown to be an independent predictor of AEs in older patients undergoing elective posterior thoracolumbar fusion surgery, especially for patients undergoing LSF.

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Section: Discussionmentioning

confidence: 99%

Section: Dovepressmentioning

confidence: 99%

<p>Frailty and Post-Operative Outcomes in the Older Patients Undergoing Elective Posterior Thoracolumbar Fusion Surgery</p>

Sun¹,

Lu²,

Kong³

et al. 2020

CIA

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“…The preoperative stratification of patients into tiered risk categories using a frailty index score could offer a surgeon with a predictive tool for major life-threatening complications; this has been reported in the general spine surgery population [39], as well as in patients undergoing cervical spinal deformity surgery [42] and ASD surgery [32,43,44]. In these studies, individuals were assigned to tiered risk groups based on frailty index threshold values; assignment to a high-risk group was predictive of the postoperative complication rate.…”

Section: Frailty and Spine Surgerymentioning

confidence: 99%

“…Some studies reported that frailty syndrome correlated with an elevated risk of infection [7,32,39,43] and pulmonary complications [35,41]. Ali et al [39] reported that in increasing frailty levels markedly elevated both wound infection rate and total postoperative infection rate in the general spine surgery population.…”

Section: Frailty and Spine Surgerymentioning

confidence: 99%

Frailty Syndrome and the Use of Frailty Indices as a Preoperative Risk Stratification Tool in Spine Surgery: A Review

et al. 2019

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This comprehensive narrative literature review aims to extract studies related to frailty indices and their use in elective spine procedures, as limited studies regarding frailty exist in the spine literature. Most studies are retrospective analyses of prospectively collected databases. Evidence suggests a positive correlation between frailty level and mortality rate, postoperative complication rate, length of stay, and the possibility of discharge to a skilled nursing facility; these correlations have been illustrated across various spine procedures. The leading index is the modified frailty index, which measures 11 deficits. The development of more comprehensive frailty indices, such as the Adult Spinal Deformity Frailty Index, are promising and have high predictive value regarding postoperative complication rate in patients with spinal deformity. However, a frailty index that combines clinical, radiographic, and laboratory measures awaits development. Perhaps, the use of a frailty index in preoperative risk stratification for elective spine procedures could serve multiple purposes, including screening for high-risk patients, enhancement of operative decision making, approximation of complication rate for informed decision making, and refinement of perioperative care. Further prospective studies are warranted to determine clinically meaningful interventions in frail individuals.

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“…Cannot do at all TRANSLATION AND ADAPTATION OF THE "LUMBAR STIFFNESS DISABILITY INDEX" QUESTIONNAIRE INTO PORTUGUESE questions contained in the LSDI are part of the frailty questionnaire (Frailty Index) that can be used to measure the frailty of patients who are candidates for spine surgery. 14 Originally published in English, to date there is no version of the LSDI translated into Portuguese and culturally adapted for the Brazilian population. Universal use of the same questionnaire is recommended in comparisons of distinct populations as it permits an analysis of both the impact of diseases in different locations and the outcome following different therapeutic approaches.…”

mentioning

confidence: 99%

Translation and Adaptation of the “Lumbar Stiffness Disability Index” Questionnaire Into Portuguese

et al. 2019

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Objective: To develop a version of the Lumbar Stiffness Disability Index (LSDI), translated into Portuguese and culturally adapted for the Brazilian population. Methods: The well-established process of translation into Portuguese and back translation into English was used together with cultural adaptation. Results: Five bilingual translators (English and Portuguese) performed the translation of the Lumbar Stiffness Disability Index (LSDI) from English to Portuguese based on interactive discussions used to arrive at a consensus translation. The translated version of LSDI was then translated into English by a native English-speaking translator who did not know the concepts involved in LSDI. The original LSDI and back translation were compared by a committee formed by the translators responsible for translating the original into Portuguese and a North-American spine surgeon, and because they were considered equivalent, the final version of the LSDI translated into Portuguese and culturally adapted was defined. Conclusions: In order to facilitate global and cross-cultural comparisons of the influence of lumbar stiffness related to spinal arthrodesis in daily activities, this study presents a version of LSDI that has been translated into Portuguese and culturally adapted for the Brazilian population. Level of Evidence; Not Applicable. Prospective Study.

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External validation of the adult spinal deformity (ASD) frailty index (ASD-FI)

Abstract: Greater patient frailty, as measured by the ASD-FI, is associated with longer hospital stays and greater odds of major complications and reoperation. These slides can be retrieved under Electronic Supplementary Material.

Cited by 54 publications

References 21 publications

<p>Frailty and Post-Operative Outcomes in the Older Patients Undergoing Elective Posterior Thoracolumbar Fusion Surgery</p>

<p>Frailty and Post-Operative Outcomes in the Older Patients Undergoing Elective Posterior Thoracolumbar Fusion Surgery</p>

Frailty Syndrome and the Use of Frailty Indices as a Preoperative Risk Stratification Tool in Spine Surgery: A Review

Translation and Adaptation of the “Lumbar Stiffness Disability Index” Questionnaire Into Portuguese

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