Impact of Frailty on Outcomes Following Spine Surgery: A Prospective Cohort Analysis of 668 Patients
| Autor: | Andrew Bilderback, Stefanie C. Altieri Dunn, Peter C. Gerszten, Robert M. Friedlander, D. Kojo Hamilton, Daniel E. Hall, Nitin Agarwal, David O. Okonkwo, Adam S. Kanter, Ezequiel Goldschmidt, Tavis Taylor, Souvik Roy |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Frail Elderly Preoperative care Risk Assessment Cohort Studies 03 medical and health sciences 0302 clinical medicine Spine surgery Venous thromboembolic disease Postoperative Complications Risk Factors Internal medicine Medicine Humans 030212 general & internal medicine Prospective Studies Adverse effect Prospective cohort study Aged Aged 80 and over Frailty business.industry Incidence (epidemiology) Length of Stay Middle Aged Exact test Treatment Outcome Surgery Female Spinal Diseases Neurology (clinical) business Risk assessment 030217 neurology & neurosurgery |
| Zdroj: | Neurosurgery. 88(3) |
| ISSN: | 1524-4040 |
| Popis: | BACKGROUND With an aging population, elderly patients with multiple comorbidities are more frequently undergoing spine surgery and may be at increased risk for complications. Objective measurement of frailty may predict the incidence of postoperative adverse events. OBJECTIVE To investigate the associations between preoperative frailty and postoperative spine surgery outcomes including mortality, length of stay, readmission, surgical site infection, and venous thromboembolic disease. METHODS As part of a system-wide quality improvement initiative, frailty assessment was added to the routine assessment of patients considering spine surgery beginning in July 2016. Frailty was assessed with the Risk Analysis Index (RAI), and patients were categorized as nonfrail (RAI 0-29) or prefrail/frail (RAI ≥ 30). Comparisons between nonfrail and prefrail/frail patients were analyzed using Fisher's exact test for categorical data or by Wilcoxon rank sum tests for continuous data. RESULTS From August 2016 through September 2018, 668 patients (age of 59.5 ± 13.3 yr) had a preoperative RAI score recorded and underwent scheduled spine surgery. Prefrail and frail patients suffered comparatively higher rates of mortality at 90 d (1.9% vs 0.2%, P |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|