The measurements of frailty and their possible application to spinal conditions: a systematic review

Moskven, Eryck; Charest-Morin, Raphaële; Flexman, Alana M.; Street, John

doi:10.1016/j.spinee.2022.03.014

Cited by 18 publications

(14 citation statements)

References 102 publications

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“…8 Moskven et al critically appraised the literature regarding frailty tools utilized in spinal surgery and found these these tools have been applied without formal evaluation of clinimetric properties, have poor objectivity, and may not be clinically applicable (e.g., lengthy questionnaires that cannot be reasonably completed in clinical practice). 10 There remains a need for clinically robust, objective tools for assessing frailty in the context of spine surgery.…”

Section: Frailty In the Smd Population: Limitations Of Current Assess...mentioning

confidence: 99%

“…7 Furthermore, the concept of frailty is ubiquitous in medicine and is increasingly recognized among the surgical spine literature for an association with adverse events, mortality, and discharge disposition. [8][9][10][11][12] Frailty may be operationalized as either a phenotypic definition of decreased physical reserve and susceptibility to stressors 13 or a composite index of accumulating deficits (e.g., symptom, disease, biochemical, and radiographic abnormalities). 14,15 Frailty indices, 16 body composition analysis, 17 and radiographic measures of sarcopenia 18 have been applied in spinal oncology; however, their validity and clinical applicability have not been established.…”

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confidence: 99%

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Perception of frailty in spinal metastatic disease: international survey of the AO Spine community

MacLean

Georgiopoulos

Charest-Morin

et al. 2023

Journal of Neurosurgery: Spine

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OBJECTIVE Frailty has not been clearly defined in the context of spinal metastatic disease (SMD). Given this, the objective of this study was to better understand how members of the international AO Spine community conceptualize, define, and assess frailty in SMD. METHODS The AO Spine Knowledge Forum Tumor conducted an international cross-sectional survey of the AO Spine community. The survey was developed using a modified Delphi technique and was designed to capture preoperative surrogate markers of frailty and relevant postoperative clinical outcomes in the context of SMD. Responses were ranked using weighted averages. Consensus was defined as ≥ 70% agreement among respondents. RESULTS Results were analyzed for 359 respondents, with an 87% completion rate. Study participants represented 71 countries. In the clinical setting, most respondents informally assess frailty and cognition in patients with SMD by forming a general perception based on clinical condition and patient history. Consensus was attained among respondents regarding the association between 14 preoperative clinical variables and frailty. Severe comorbidities, extensive systemic disease burden, and poor performance status were most associated with frailty. Severe comorbidities associated with frailty included high-risk cardiopulmonary disease, renal failure, liver failure, and malnutrition. The most clinically relevant outcomes were major complications, neurological recovery, and change in performance status. CONCLUSIONS The respondents recognized that frailty is important, but they most commonly evaluate it based on general clinical impressions rather than using existing frailty tools. The authors identified numerous preoperative surrogate markers of frailty and postoperative clinical outcomes that spine surgeons perceived as most relevant in this population.

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Section: Frailty In the Smd Population: Limitations Of Current Assess...mentioning

confidence: 99%

mentioning

confidence: 99%

Perception of frailty in spinal metastatic disease: international survey of the AO Spine community

MacLean

Georgiopoulos

Charest-Morin

et al. 2023

Journal of Neurosurgery: Spine

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“…Recently, studies have suggested that frailty may be an effective predictor of adverse events in an older patient population [4] , [5] , [6] . Several frailty indices have been developed to assist surgeons in risk stratification following lumbar fusion [7] , [8] , [9] , [10] . One such frailty index is the 11-factor modified frailty index (mFI-11), which has shown predictive capabilities for adverse events following various forms of thoracolumbar surgery [11] , [12] , [13] , [14] .…”

Section: Introductionmentioning

confidence: 99%

The 5-factor modified Frailty Index (mFI-5) predicts adverse outcomes after elective Anterior Lumbar Interbody Fusion (ALIF)

Patel

Elali

Coban

et al. 2023

North American Spine Society Journal (NASSJ)

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“…What’s more, the expense of MRI is significant, and some patients are still unable to undergo MRI due to contraindications or other issues. There have been multiple previous investigations applying frailty scales for spine research [ 12 ], while few of study on the application of FRAIL scales in the assessment of paraspinal muscles.…”

Section: Introductionmentioning

confidence: 99%

Morphology of paraspinal muscles in frail and non-frail older adults evaluated through FRAIL scale

Huang

Fang

Kong

et al. 2023

BMC Musculoskelet Disord

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Background Frailty is a condition characterized by the progressive deterioration of physiological functioning, which is closely related to adverse events. Multiple previous investigations applied frailty scales for spine research, and the purpose of this study is to investigate the differences in the morphology of the paraspinal muscles in frail and non-frail older adults evaluated through FRAIL scale. Methods The sample of this retrospectively cross-sectional study consisted of individuals who were ≥ 60 years of age and with lumbar degenerative disease. We divided patients into two groups (0–2 = non-Frail, 3–5 = Frail) according to the FRAIL scale. The cross-sectional area (CSA) and percentage of the fatty infiltration (FI%) of the paraspinal muscles were compared between the two groups. Results The fCSA (functional cross-sectional area) of the non-Frail group (32.78 [28.52, 38.28]) (cm2) was significantly greater than that of the Frail group (28.50 [24.11, 34.77]) (p < 0.001). The ES FI% (erector spinae fatty infiltration rate) (24.83 ± 6.61 vs. 29.60 ± 7.92, p < 0.001) and MF FI% (multifidus fatty infiltration rate) (31.68 ± 5.63 vs. 41.12 ± 7.04, p < 0.001) of the non-Frail group were significantly lower than that of Frail group. Conclusions The paraspinal muscles of elderly Frail patients screened by the FRAIL scale are worse than those of the non-Frail patients, and the ability of the FRAIL scale to distinguish paraspinal muscle morphology has important clinical significance.

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The measurements of frailty and their possible application to spinal conditions: a systematic review

Cited by 18 publications

References 102 publications

Perception of frailty in spinal metastatic disease: international survey of the AO Spine community

Perception of frailty in spinal metastatic disease: international survey of the AO Spine community

The 5-factor modified Frailty Index (mFI-5) predicts adverse outcomes after elective Anterior Lumbar Interbody Fusion (ALIF)

Morphology of paraspinal muscles in frail and non-frail older adults evaluated through FRAIL scale

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