The 5-factor modified frailty index (mFI-5) is predictive of 30-day postoperative complications and readmission in patients with adult spinal deformity (ASD).

Autor: Shah NV; Department of Orthopaedic Surgery and Rehabilitation Medicine, The State University of New York (SUNY) Downstate Health Sciences University, Brooklyn, NY, USA. Electronic address: neil.shah@downstate.edu., Kim DJ; Department of Orthopaedic Surgery and Rehabilitation Medicine, The State University of New York (SUNY) Downstate Health Sciences University, Brooklyn, NY, USA., Patel N; Department of Orthopaedic Surgery and Rehabilitation Medicine, The State University of New York (SUNY) Downstate Health Sciences University, Brooklyn, NY, USA., Beyer GA; Department of Orthopaedic Surgery and Rehabilitation Medicine, The State University of New York (SUNY) Downstate Health Sciences University, Brooklyn, NY, USA., Hollern DA; Department of Orthopedic Surgery, USC Verdugo Hills Hospital, Los Angeles, CA, USA., Wolfert AJ; Department of Orthopaedic Surgery and Rehabilitation Medicine, The State University of New York (SUNY) Downstate Health Sciences University, Brooklyn, NY, USA., Kim N; Department of Orthopaedic Surgery and Rehabilitation Medicine, The State University of New York (SUNY) Downstate Health Sciences University, Brooklyn, NY, USA., Suarez DE; Department of Orthopaedic Surgery and Rehabilitation Medicine, The State University of New York (SUNY) Downstate Health Sciences University, Brooklyn, NY, USA., Monessa D; Department of Orthopaedic Surgery and Rehabilitation Medicine, The State University of New York (SUNY) Downstate Health Sciences University, Brooklyn, NY, USA., Zhou PL; Department of Orthopaedic Surgery and Rehabilitation Medicine, The State University of New York (SUNY) Downstate Health Sciences University, Brooklyn, NY, USA., Eldib HM; Department of Orthopaedic Surgery and Rehabilitation Medicine, The State University of New York (SUNY) Downstate Health Sciences University, Brooklyn, NY, USA., Passias PG; Department of Orthopedic Surgery, NYU Langone Orthopedic Hospital, New York, NY, USA., Schwab FJ; Department of Orthopaedic Surgery, Lenox Hill Hospital, Northwell Health, New York, NY, USA., Lafage V; Department of Orthopaedic Surgery, Lenox Hill Hospital, Northwell Health, New York, NY, USA., Paulino CB; Department of Orthopaedic Surgery and Rehabilitation Medicine, The State University of New York (SUNY) Downstate Health Sciences University, Brooklyn, NY, USA; Department of Orthopaedic Surgery, New York Presbyterian-Brooklyn Methodist Hospital, Brooklyn, NY, USA., Diebo BG; Department of Orthopaedic Surgery and Rehabilitation Medicine, The State University of New York (SUNY) Downstate Health Sciences University, Brooklyn, NY, USA; Department of Orthopaedic Surgery, Warren Alpert School of Medicine, Brown University, Providence, RI, USA.
Jazyk: angličtina
Zdroj: Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia [J Clin Neurosci] 2022 Oct; Vol. 104, pp. 69-73. Date of Electronic Publication: 2022 Aug 15.
DOI: 10.1016/j.jocn.2022.07.020
Abstrakt: Background: There is limited research regarding the association between the mFI-5 and postoperative complications among adult spinal deformity (ASD) patients.
Methods: Using the National Surgical Quality Improvement Project (NSQIP) database, patients with Current Procedural Terminology (CPT) codes for > 7-level fusion or < 7-level fusion with International Classification of Diseases, Ninth Revision (ICD-9) codes for ASD were identified between 2008 and 2016. Univariate analyses with post-hoc Bonferroni correction for demographics and preoperative factors were performed. Logistic regression assessed associations between mFI-5 scores and 30-day post-operative outcomes.
Results: 2,120 patients met criteria. Patients with an mFI-5 score of 4 or 5 were excluded, given there were<20 patients with those scores. Patients with mFI-5 scores of 1 and 2 had increased 30-day rates of pneumonia (3.5 % and 4.3 % vs 1.6 %), unplanned postoperative ventilation for > 48 h (3.1 % and 4.3 % vs 0.9 %), and UTIs (4.4 % and 7.4 % vs 2.0 %) than patients with a score of 0 (all, p < 0.05). Logistic regression revealed that compared to an mFI-5 of 0, a score of 1 was an independent predictor of 30-day reoperations (OR = 1.4; 95 % CI 1.1-18). A score of 2 was an independent predictor of overall (OR = 2.4; 95 % CI 1.4-4.1) and related (OR = 2.2; 95 % CI 1.2-4.1) 30-day readmissions. A score of 3 was not predictive of any adverse outcome.
Conclusion: The mFI-5 score predicted complications and postoperative events in the ASD population. The mFI-5 may effectively predict 30-day readmissions. Further research is needed to identify the benefits and predictive value of mFI-5 as a risk assessment tool.
Competing Interests: Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: The following authors have no conflicts of interest to report: NVS, DJK, NP, GAB, DAH, AJW, NK, DES, DM, PLZ, HME, CBP, BGD. PGP has received grant funding from CSRS, speaker and consultant honoraria from Globus Medical, Medicrea, SpineWave, and Zimmer, and other financial support from Allosource. FJS has received grant funding from DePuy, NuVasive, Allosource, K2M, Medtronic, and Si Bone, speaker and consultant honoraria from Globus Medical, Mainstay Medical, Medtronic, and ZimmerBiomet, royalties from Medicrea, Medtronic, and Zimmer, and serves on boards or committees for SRS, Spine Deformity, and ISSG. VL has received grant funding from DePuy, , NuVasive, Allosource, K2M, Medtronic, and Si-Bone, speaker and consultant honoraria from Globus Medical, DePuy, and Stryker, stock in VFT Solutions, and serves on boards or committees for ISSG and SRS. For the remaining authors none were declared.
(Copyright © 2022 Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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