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Frailty as a Predictor of Postoperative Morbidity and Mortality in Patients Aged 80 Years and Older Undergoing Instrumented Fusion – Lumbar Fusion

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This article discusses a study that aimed to determine the most predictive frailty score for adverse events in patients aged 80 and older undergoing instrumented lumbar fusion. The study included 153 patients and found that the Modified Frailty Index-11 (MFI-11) score correlated with adverse events, while the Modified Frailty Index-5 (MFI-5) and Charlson Comorbidity Index (CCI) scores did not reach statistical significance. The study highlights the limited predictive ability of existing frailty scores and suggests the need for better approaches to identify high-risk patients in this age group

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : best recognised spine facility on Harley Street UK

Published article

: This is the largest study comparing frailty index scores in octogenarians undergoing instrumented lumbar fusion. Our findings suggest that while MFI-11 score correlated with adverse events, the predictive ability of existing scores remains limited, highlighting the need for better approaches to identify select patients at age extremes.

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Oper Neurosurg (Hagerstown). 2024 Jan 8. doi: 10.1227/ons.0000000000001040. Online ahead of print.ABSTRACTBACKGROUND AND OBJECTIVES: Degenerative spine disease is a leading cause of disability, with increasing prevalence in the older patients. While age has been identified as an independent predictor of outcomes, its predictive value is limited for similar older patients. Here, we aimed to determine,

Oper Neurosurg (Hagerstown). 2024 Jan 8. doi: 10.1227/ons.0000000000001040. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVES: Degenerative spine disease is a leading cause of disability, with increasing prevalence in the older patients. While age has been identified as an independent predictor of outcomes, its predictive value is limited for similar older patients. Here, we aimed to determine the most predictive frailty score of adverse events in patients aged 80 and older undergoing instrumented lumbar fusion.

METHODS: We proceeded with a multisite (3 tertiary academic centers) retrospective review including patients undergoing instrumented fusion aged 80 and older from January 2010 to present. A composite end point encompassing 30-day return to operating room, readmission, and mortality was created. We estimated the area under the receiver operating characteristic curve for frailty scores (Modified Frailty Index-5 [MFI-5]Modified Frailty Index-11 [MFI-11]and Charlson Comorbidity Index [CCI]) in relation to that composite score. In addition, we estimated the association between each score and the composite end point by means of logistic regression.

RESULTS: A total of 153 patients with an average age of 85 years at the time of surgery were included. We observed a 30-day readmission rate of 11.1%, reoperation of 3.9%, and mortality of 0.6%. The overall rate of the composite end point at 30 days was 25 (15.1%). The AUC for MFI-5 was 0.597 (0.501-0.693), for MFI-11 was 0.620 (0.518-0.723), and for CCI was 0.564 (0.453-0.675). The association between the scores and composite end point did not reach statistical significance for MFI-5 (odds ratio [OR] = 1.45 [0.98-2.15]P = .061) and CCI (OR = 1.13 [0.97-1.31]P = .113) but was statistically significant for MFI-11 (OR = 1.46 [1.07-2.00]P = .018).

: This is the largest study comparing frailty index scores in octogenarians undergoing instrumented lumbar fusion. Our findings suggest that while MFI-11 score correlated with adverse events, the predictive ability of existing scores remains limited, highlighting the need for better approaches to identify select patients at age extremes.

PMID:38189376 | DOI:10.1227/ons.0000000000001040

The London Spine Unit : best recognised spine facility on Harley Street UK

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Frailty as a Predictor of Postoperative Morbidity and Mortality in Patients Aged 80 Years and Older Undergoing Instrumented Fusion

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Oper Neurosurg (Hagerstown). 2024 Jan 8. doi: 10.1227/ons.0000000000001040. Online ahead of print.ABSTRACTBACKGROUND AND OBJECTIVES: Degenerative spine disease is a leading cause of disability, with increasing prevalence in the older patients. While age has been identified as an independent predictor of outcomes, its predictive value is limited for similar older patients. Here, we aimed to determine

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