La Frailty as a predictor index in spine surgery

Area of Science:

• Geriatric Medicine
• Neurosurgery
• Surgical Outcomes

Background:

• Frailty is a key indicator of physiological age and is linked to increased surgical risks.
• Understanding frailty's impact is crucial for optimizing patient care and outcomes in complex procedures.

Purpose of the Study:

• To investigate the association between frailty, using the Modified Frailty Index (mFI), and postoperative complications within 90 days.
• To specifically evaluate complication and mortality rates following elective spinal surgeries in relation to frailty status.

Main Methods:

• A retrospective observational study analyzed 257 adult patients undergoing elective spine surgery.
• Patients were stratified by the Modified Frailty Index (mFI) with a cutoff of 0.18.
• Data on demographics, surgical details, length of stay, complications, and mortality were collected and analyzed.

Main Results:

• A total of 30 complications were recorded; 16 in non-frail (8%) and 14 in frail patients (24.5%), (p=0.02).
• Infectious complications were significantly higher in frail patients (10.5%) compared to non-frail (2%), (p=0.009).
• No significant differences were found in surgery duration, length of stay, reoperations, rehospitalizations, or mortality rates.

Conclusions:

• A Modified Frailty Index (mFI) of ≥0.18 identifies patients at a significantly higher risk of complications after elective spine surgery.
• Infectious complications are a particular concern for frail patients undergoing these procedures.