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

Wenzhi Sun, Shibao Lu, Chao Kong, Zhongen Li, Peng Wang, Sitao Zhang Department of Orthopaedics, Capital Medical University Xuanwu Hospital, Beijing 100053, People’s Republic of ChinaCorrespondence: Shibao Lu Email xuanwuspine@sina.comBackground and Aim: Frailty is an independent predictor...

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Autores principales:	Sun W, Lu S, Kong C, Li Z, Wang P, Zhang S
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2020
Materias:	frailty degenerative spine disease spinal surgery elderly clinical evaluation complications risk stratification Geriatrics RC952-954.6
Acceso en línea:	https://doaj.org/article/4d0f63196c1d4d5d9177a87711a1d18c
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spelling	oai:doaj.org-article:4d0f63196c1d4d5d9177a87711a1d18c2021-12-02T11:16:44ZFrailty and Post-Operative Outcomes in the Older Patients Undergoing Elective Posterior Thoracolumbar Fusion Surgery1178-1998https://doaj.org/article/4d0f63196c1d4d5d9177a87711a1d18c2020-07-01T00:00:00Zhttps://www.dovepress.com/frailty-and-post-operative-outcomes-in-the-older-patients-undergoing-e-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Wenzhi Sun, Shibao Lu, Chao Kong, Zhongen Li, Peng Wang, Sitao Zhang Department of Orthopaedics, Capital Medical University Xuanwu Hospital, Beijing 100053, People’s Republic of ChinaCorrespondence: Shibao Lu Email xuanwuspine@sina.comBackground 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 11-variable 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.Keywords: frailty, degenerative spine disease, spinal surgery, elderly, clinical evaluation, complications, risk stratificationSun WLu SKong CLi ZWang PZhang SDove Medical Pressarticlefrailtydegenerative spine diseasespinal surgeryelderlyclinical evaluationcomplicationsrisk stratificationGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 15, Pp 1141-1150 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	frailty degenerative spine disease spinal surgery elderly clinical evaluation complications risk stratification Geriatrics RC952-954.6
spellingShingle	frailty degenerative spine disease spinal surgery elderly clinical evaluation complications risk stratification Geriatrics RC952-954.6 Sun W Lu S Kong C Li Z Wang P Zhang S Frailty and Post-Operative Outcomes in the Older Patients Undergoing Elective Posterior Thoracolumbar Fusion Surgery
description	Wenzhi Sun, Shibao Lu, Chao Kong, Zhongen Li, Peng Wang, Sitao Zhang Department of Orthopaedics, Capital Medical University Xuanwu Hospital, Beijing 100053, People’s Republic of ChinaCorrespondence: Shibao Lu Email xuanwuspine@sina.comBackground 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 11-variable 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.Keywords: frailty, degenerative spine disease, spinal surgery, elderly, clinical evaluation, complications, risk stratification
format	article
author	Sun W Lu S Kong C Li Z Wang P Zhang S
author_facet	Sun W Lu S Kong C Li Z Wang P Zhang S
author_sort	Sun W
title	Frailty and Post-Operative Outcomes in the Older Patients Undergoing Elective Posterior Thoracolumbar Fusion Surgery
title_short	Frailty and Post-Operative Outcomes in the Older Patients Undergoing Elective Posterior Thoracolumbar Fusion Surgery
title_full	Frailty and Post-Operative Outcomes in the Older Patients Undergoing Elective Posterior Thoracolumbar Fusion Surgery
title_fullStr	Frailty and Post-Operative Outcomes in the Older Patients Undergoing Elective Posterior Thoracolumbar Fusion Surgery
title_full_unstemmed	Frailty and Post-Operative Outcomes in the Older Patients Undergoing Elective Posterior Thoracolumbar Fusion Surgery
title_sort	frailty and post-operative outcomes in the older patients undergoing elective posterior thoracolumbar fusion surgery
publisher	Dove Medical Press
publishDate	2020
url	https://doaj.org/article/4d0f63196c1d4d5d9177a87711a1d18c
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Frailty and Post-Operative Outcomes in the Older Patients Undergoing Elective Posterior Thoracolumbar Fusion Surgery

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