Modified-frailty index does not independently predict complications, hospital length of stay or 30-day readmission rates following posterior lumbar decompression and fusion for spondylolisthesis

Elsamadicy, Aladine A.; Freedman, Isaac G.; Koo, Andrew B.; David, Wyatt B.; Reeves, Benjamin C.; Havlík, J; Pennington, Zach; Kolb, Luis; Shin, John H.; Sciubba, Daniel M.

doi:10.1016/j.spinee.2021.05.011

Cited by 20 publications

(32 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Continuous variables were analyzed using the t-test or analysis of variance, and the Bonferroni test was used for post hoc analysis, while categorical variables was analyzed using the Chi-square test or the Fisher's exact test. According to previous studies, [16][17][18] we posited that frailty was significantly related to age. Hence, a 1:1 nearest-neighbor PSM for age, sex, fusion levels, and ASA was implemented between non-frail group and pre-frail group to keep preoperative comparable clinical data as much as possible.…”

Section: Discussionmentioning

confidence: 95%

“…Shahrestani et al 24 reported that frail patients encountered higher rate of urinary tract infection, infection, and 30-day readmission. Nevertheless, in a retrospective review of 5296 patients, Elsamadicy et al 18 reported that the modified frailty index did not independently predict complications. In the present study, while there were higher rates of urinary retention (p = 0.031), and surgical site infection (p = 0.021) in pre-frail patients than in non-frail patients, there were no significant differences in other complications, binary logistic regression indicated that pre-frail was independently related to postoperative complications.…”

Section: Discussionmentioning

confidence: 99%

“…However, it cannot be ignored that frailty is significantly related to increasing age, verified in previous studies. [16][17][18] On the other hand, in previous literatures, patients were dichotomized into non-frail and pre-frail/frail groups, without considering pre-frail as an independent group. 16,24 Therefore, we employed PSM for age, sex, ASA and fusion levels in the present study to guarantee comparable clinical characteristics between groups.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

The Impact of Frailty on Perioperative Outcomes in Patients Receiving Short-Level Posterior Lumbar Interbody Fusion: A Stepwise Propensity Score Matching Analysis

Cui¹,

Wang²,

Wang³

et al. 2022

CIA

View full text Add to dashboard Cite

Background: There are many studies on the impact of frailty on postoperative complications; however, there are few studies focusing on stepwise propensity score matching (PSM) to offset the influence of age. Methods: We gathered data for patients undergoing short-level posterior lumbar interbody fusion from January to December 2021. According to the Fried frailty phenotype, we categorized patients into non-frail, pre-frail, and frail groups, then, stepwise PSM for age, sex, American Society of Anesthesiologists (ASA) and fusion levels were performed to keep comparable clinical data between groups. Univariate and multivariate logistic regressions were used to determine the impact of clinical demographics on postoperative complications. Results: A total of 559 consecutive patients with complete medical records were enrolled (237 males and 322 females; mean age 72.55 ± 5.86 years). After PSM, we found that pre-frail patients were more vulnerable to develop urinary retention (p = 0.031) and surgical site infections (p = 0.021) than non-frail patients. Longer length of stay (LOS), delayed ambulation and removal of urinary catheter times were observed in pre-frail patients. However, there was a significant difference only in LOS between pre-frail and frail patients. Binary logistic regression revealed that C-reactive protein (CRP) and frail status were independently associated with postoperative complications between non-frail and pre-frail patients, while only CRP was independently correlated with complications between pre-frail and frail patients. Conclusion: After PSM, we found higher rates of urinary retention and surgical site infections in pre-frail patients than in non-frail patients. CRP was independently related to postoperative complications, while frail status was only independently associated with postoperative complications between pre-frail and non-frail patients. Pre-frail/frail patients tended to have more severe stress responses than non-frail patients.

show abstract

Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

The Impact of Frailty on Perioperative Outcomes in Patients Receiving Short-Level Posterior Lumbar Interbody Fusion: A Stepwise Propensity Score Matching Analysis

Cui¹,

Wang²,

Wang³

et al. 2022

CIA

View full text Add to dashboard Cite

show abstract

“…This wide distribution reveals that there is a unique subpopulation. However, the cause of the discrepancy is unclear, suggesting that further research on patients undergoing posterior lumbar interbody fusion is needed [32].…”

Section: Discussionmentioning

confidence: 99%

Efficacy of the five-item modified frailty index for predicting a poor prognosis in patients undergoing posterior lumbar interbody fusion surgery for lumbar spinal stenosis

Shin

Kim

2022

J Korean Soc Geriatr Neurosurg

View full text Add to dashboard Cite

Objective: This study aimed to determine whether preoperative frailty assessed using the five-item modified frailty index (mFI-5) in patients undergoing posterior lumbar interbody fusion for lumbar spinal stenosis can predict poor patient outcomes.Methods: We retrospectively included 192 patients aged 18 years or older who were diagnosed with lumbar spinal stenosis and underwent posterior lumbar interbody fusion at a single hospital between March 2009 and February 2021. We calculated mFI-5 scores for these patients based on the following five comorbidities: (1) hypertension requiring medication, (2) diabetes mellitus, (3) history of chronic obstructive pulmonary disease or pneumonia, (4) history of congestive heart failure in the 30 days before surgery, and (5) partially or totally dependent functional health status at the time of surgery. The patients were categorized into three groups according to their mFI-5 scores, and these groups were analyzed. A P<0.05 was considered statistically significant in all analyses.Results: Length of hospital stay (LOS) was significantly associated with mFI-5 score (β=0.196, P=0.008), age (β=0.112, P=0.159), and surgical level (β=0.238, P<0.001). In patients with fusion at one or two levels, mFI-5 score showed the greatest association with LOS (β=0.188, P=0.016), followed by sex (β=0.137, P=0.065) and the number of fused segments (β=0.137, P=0.065).Conclusion: Frailty may not be an independent predictor, but it has significant predictive power for LOS in patients undergoing posterior lumbar interbody fusion for lumbar spinal stenosis, especially in patients undergoing fusion at one or two levels.

show abstract

“…Despite the overwhelming evidence of its predictive power, there are some instances where the mFI-5 index has been proven to be a poor prognostic tool. length of stay, 30-day adverse events, or 30-day unplanned readmission in patients undergoing lumbar spinal decompression and fusion for spondylolisthesis 18 . Thus, it is important to continue to assess the predictive value of the mFI-5 in various spine surgeries and otherwise.…”

mentioning

confidence: 99%

The 5-Item Modified Frailty Index Independently Predicts Morbidity in Patients Undergoing Instrumented Fusion following Extradural Tumor Removal

Strigenz

Katz

Lee-Seitz

et al. 2023

Spine Surg Relat Res

View full text Add to dashboard Cite

show abstract

Modified-frailty index does not independently predict complications, hospital length of stay or 30-day readmission rates following posterior lumbar decompression and fusion for spondylolisthesis

Cited by 20 publications

References 32 publications

The Impact of Frailty on Perioperative Outcomes in Patients Receiving Short-Level Posterior Lumbar Interbody Fusion: A Stepwise Propensity Score Matching Analysis

The Impact of Frailty on Perioperative Outcomes in Patients Receiving Short-Level Posterior Lumbar Interbody Fusion: A Stepwise Propensity Score Matching Analysis

Efficacy of the five-item modified frailty index for predicting a poor prognosis in patients undergoing posterior lumbar interbody fusion surgery for lumbar spinal stenosis

The 5-Item Modified Frailty Index Independently Predicts Morbidity in Patients Undergoing Instrumented Fusion following Extradural Tumor Removal

Contact Info

Product

Resources

About