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The 5-Factor Modified Frailty Index Score Predicts Return to the Operating Room for Patients Undergoing Posterior
Yusuf Mehkri1, Sachiv Chakravarti2, Ramy Sharaf1
1Department of Neurosurgery, University of Florida College of Medicine, Gainesville, Florida, USA.
World Neurosurgery
|April 30, 2023
Summary
Patient frailty, measured by the modified frailty index (mFI-5), independently predicts return to the operating room (OR) after posterior spinal fusion (PSF) for traumatic spine injuries. This highlights the importance of assessing frailty in surgical planning.
Area of Science:
- Orthopedics
- Neurosurgery
- Geriatric Medicine
Background:
- Patient frailty is increasingly recognized as a significant factor influencing surgical outcomes.
- The impact of frailty on outcomes following posterior spinal fusion (PSF) for traumatic spine injuries requires further elucidation.
- The 5-factor modified frailty index (mFI-5) is a validated tool for assessing patient frailty.
Purpose of the Study:
- To quantify the influence of the mFI-5 score on postoperative outcomes in patients undergoing PSF for traumatic spine injuries.
- To determine if frailty independently predicts adverse outcomes such as prolonged hospital stay, infection, readmission, and return to the operating room (OR).
Main Methods:
- Retrospective review of 263 patients who underwent PSF for traumatic spine injury between 2016 and 2021.
- Calculation of the mFI-5 score based on patient comorbidities.
- Bivariate and multivariate regression analyses to assess the relationship between mFI-5 score and postoperative outcomes.
Main Results:
- 67 patients (25.5%) were classified as frail (mFI-5 score ≥2).
- Frail patients were older, had higher BMI, and were more likely to have diabetes and active cancer.
- mFI-5 score independently predicted return to the OR (OR=1.294, P=0.041) after controlling for confounding factors.
Conclusions:
- Patient frailty, as assessed by the mFI-5 score, is an independent predictor of return to the OR in patients undergoing PSF for traumatic spine injuries.
- These findings underscore the importance of frailty assessment in optimizing surgical planning and patient management.
- Further research should explore strategies to mitigate the risks associated with frailty in this patient population.
