Frailty as a Superior Predictor of Dysphagia and Surgically Placed Feeding Tube Requirement After Anterior Cervical Discectomy and Fusion Relative to Age

Naftchi, Alexandria; Vellek, John; Stack, Julia; Spirollari, Eris; Vazquez, Sima; Das, Ankita; Greisman, Jacob D.; Stadlan, Zehavya; Tarawneh, Omar; Zeller, Sabrina; Dominguez, Jose F.; Kinon, Merritt D.; Gandhi, Chirag D.; Kazim, Syed Faraz; Schmidt, Meic H.; Bowers, Christian A.

doi:10.1007/s00455-022-10505-6

Cited by 7 publications

(7 citation statements)

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“…In our study, a higher proportion of patients under 65 years (82.1%) were included compared with a previous study of the national database (71.1%). 21 Despite this age distribution, frailty was demonstrated to be significantly associated with postoperative dysphagia in this study. A study utilizing hypoalbuminemia, muscle weakness, or fatigue as indicators of frailty reported higher OR of postoperative dysphagia in frail patients.…”

Section: Discussionmentioning

confidence: 50%

“…The mFI-11 has often been reported as a predictor of systemic complications after spinal surgery compared with age. 20,21,26 The assessment of frail is not solely restricted to the elderly population; it also may hold significant importance for young adults regarding postoperative dysphagia after ACSS. In our study, a higher proportion of patients under 65 years (82.1%) were included compared with a previous study of the national database (71.1%).…”

Section: Discussionmentioning

confidence: 99%

“…The mFI-11 has often been reported as a predictor of systemic complications after spinal surgery compared with age 20,21,26 . The assessment of frail is not solely restricted to the elderly population; it also may hold significant importance for young adults regarding postoperative dysphagia after ACSS.…”

Section: Discussionmentioning

confidence: 99%

“…Thus, literature examining the relationship between frailty status and dysphagia after ACSS is sparse. 21 This study aims to investigate the impact of frailty on postoperative dysphagia after ACSS and thereby elucidate the utility of preoperative frailty assessment as a predictive factor. We hypothesize that preoperative frailty increases the risk of postoperative dysphagia after ACSS.…”

mentioning

confidence: 99%

“…However, these studies are often based on large cohorts from national databases and do not describe complications specific to spine surgery. Thus, literature examining the relationship between frailty status and dysphagia after ACSS is sparse 21 …”

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confidence: 99%

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Impact of Frailty and Cervical Radiographic Parameters on Postoperative Dysphagia Following Anterior Cervical Spine Surgery

Asada,

Singh,

Maayan

et al. 2023

Spine

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Study Design. Retrospective review of a prospectively collected registry Objective. The purpose of the present study was to investigate the impact of frailty and radiographical parameters on postoperative dysphagia after anterior cervical spine surgery (ACSS). Summary of Background Data. There is a growing body of literature indicating an association between frailty and increased postoperative complications following various surgeries. However, few studies have investigated the relationship between frailty and postoperative dysphagia after anterior cervical spine surgery. Materials and Methods. Patients who underwent anterior cervical spine surgery for the treatment of degenerative cervical pathology were included. Frailty and dysphagia were assessed by the modified frailty index-11 (mFI-11) and eat assessment tool-10 (EAT-10), respectively. We also collected clinical demographics and cervical alignment parameters previously reported as risk factors for postoperative dysphagia. Multivariable logistic regression was performed to identify the odds ratio (OR) of postoperative dysphagia at early (2-6 weeks) and late postoperative timepoints (1-2 years). Results. Ninety-five patients who underwent ACSS were included in the study. Postoperative dysphagia occurred in 31 patients (32.6%) at the early postoperative timepoint. Multivariable logistic regression identified higher mFI-11 score (OR, 4.03; 95%CI 1.24–13.16; P=0.021), over-correction of TS-CL after surgery (TS-CL, T1 slope minus C2-7 lordosis; OR, 0.86; 95% CI 0.79–0.95; P=0.003), and surgery at C3/4 (OR, 12.38; 95% CI 1.41–108.92; P=0.023) as factors associated with postoperative dysphagia. Conclusion. Frailty, as assessed by the mFI-11, was significantly associated with postoperative dysphagia after ACSS. Additional factors associated with postoperative dysphagia were over-correction of TS-CL and surgery at C3/4. These findings emphasize the importance of assessing frailty and cervical alignment in the decision-making process preceding ACSS.

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Section: Discussionmentioning

confidence: 50%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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