PMID- 31407621 OWN - NLM STAT- MEDLINE DCOM- 20210810 LR - 20210810 IS - 1557-9042 (Electronic) IS - 0897-7151 (Linking) VI - 37 IP - 6 DP - 2020 Mar 15 TI - Effect of Frailty on Outcome after Traumatic Spinal Cord Injury. PG - 839-845 LID - 10.1089/neu.2019.6581 [doi] AB - Frailty negatively affects outcome in elective spine surgery populations. This study sought to determine the effect of frailty on patient outcome after traumatic spinal cord injury (tSCI). Patients with tSCI were identified from our prospectively collected database from 2004 to 2016. We examined effect of patient age, admission Total Motor Score (TMS), and Modified Frailty Index (mFI) on adverse events (AEs), acute length of stay (LOS), in-hospital mortality, and discharge destination (home vs. other). Subgroup analysis (for three age groups: <60, 61-75, and 76+ years), and multi-variable analysis was performed to investigate the impact of age, TMS, and mFI on outcome. For the 634 patients, the mean age was 50.3 years, 77% were male, and falls were the main cause of injury (46.5%). On bivariate analysis, mFI, age at injury, and TMS were predictors of AEs, acute LOS, and in-hospital mortality. After statistical adjustment, mFI was a predictor of LOS (p = 0.0375), but not of AEs (p = 0.1428) or in-hospital mortality (p = 0.1245). In patients <60 years of age, mFI predicted number of AEs, acute LOS, and in-hospital mortality. In those aged 61-75, TMS predicted AEs, LOS, and mortality. In those 76+ years of age, mFI no longer predicted outcome. Age, mFI, and TMS on admission are important determinants of outcome in patients with tSCI. mFI predicts outcomes in those <75 years of age only. The inter-relationship of advanced age and decreased physiological reserve is complex in acute tSCI, warranting further study. Identifying frailty in younger patients with tSCI may be useful for peri-operative optimization, risk stratification, and patient counseling. FAU - Banaszek, Dan AU - Banaszek D AD - Vancouver Spine Surgery Institute, Department of Orthopaedics, University of British Columbia, Vancouver, British Columbia, Canada. FAU - Inglis, Tom AU - Inglis T AD - Vancouver Spine Surgery Institute, Department of Orthopaedics, University of British Columbia, Vancouver, British Columbia, Canada. FAU - Marion, Travis E AU - Marion TE AD - Division of Orthopaedic Surgery, Northern Ontario School of Medicine, Thunder Bay, Ontario, Canada. FAU - Charest-Morin, Raphaele AU - Charest-Morin R AD - Vancouver Spine Surgery Institute, Department of Orthopaedics, University of British Columbia, Vancouver, British Columbia, Canada. FAU - Moskven, Eryck AU - Moskven E AD - Vancouver Spine Surgery Institute, Department of Orthopaedics, University of British Columbia, Vancouver, British Columbia, Canada. FAU - Rivers, Carly S AU - Rivers CS AD - Rick Hansen Institute, Vancouver, British Columbia, Canada. FAU - Kurban, Dilnur AU - Kurban D AD - Rick Hansen Institute, Vancouver, British Columbia, Canada. FAU - Flexman, Alana M AU - Flexman AM AD - Department of Anesthesiology, Pharmacology, and Therapeutics, University of British Columbia, Vancouver, British Columbia, Canada. AD - Department of Anesthesiology and Perioperative Care, Vancouver General Hospital, Vancouver, British Columbia, Canada. FAU - Ailon, Tamir AU - Ailon T AD - Vancouver Spine Surgery Institute, Division of Neurosurgery, Department of Surgery, University of British Columbia, Vancouver, British Columbia, Canada. FAU - Dea, Nicolas AU - Dea N AD - Vancouver Spine Surgery Institute, Division of Neurosurgery, Department of Surgery, University of British Columbia, Vancouver, British Columbia, Canada. FAU - Kwon, Brian K AU - Kwon BK AD - Vancouver Spine Surgery Institute, Department of Orthopaedics, University of British Columbia, Vancouver, British Columbia, Canada. AD - International Collaboration on Repair Discoveries (ICORD), Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada. FAU - Paquette, Scott AU - Paquette S AD - Vancouver Spine Surgery Institute, Division of Neurosurgery, Department of Surgery, University of British Columbia, Vancouver, British Columbia, Canada. FAU - Fisher, Charles G AU - Fisher CG AD - Vancouver Spine Surgery Institute, Department of Orthopaedics, University of British Columbia, Vancouver, British Columbia, Canada. FAU - Dvorak, Marcel F AU - Dvorak MF AD - Vancouver Spine Surgery Institute, Department of Orthopaedics, University of British Columbia, Vancouver, British Columbia, Canada. AD - International Collaboration on Repair Discoveries (ICORD), Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada. FAU - Street, John T AU - Street JT AD - Vancouver Spine Surgery Institute, Department of Orthopaedics, University of British Columbia, Vancouver, British Columbia, Canada. AD - International Collaboration on Repair Discoveries (ICORD), Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada. LA - eng PT - Journal Article DEP - 20191108 PL - United States TA - J Neurotrauma JT - Journal of neurotrauma JID - 8811626 SB - IM MH - Adult MH - Aged MH - Aged, 80 and over MH - Cervical Vertebrae/injuries MH - Cohort Studies MH - Female MH - Frailty/diagnosis/*mortality/*therapy MH - Hospital Mortality/*trends MH - Humans MH - Lumbar Vertebrae/injuries MH - Male MH - Middle Aged MH - Prospective Studies MH - Retrospective Studies MH - Spinal Cord Injuries/diagnosis/*mortality/*therapy MH - Thoracic Vertebrae/injuries MH - Treatment Outcome OTO - NOTNLM OT - aging OT - deficit OT - frailty OT - prognosis OT - spinal cord injury EDAT- 2019/08/14 06:00 MHDA- 2021/08/11 06:00 CRDT- 2019/08/14 06:00 PHST- 2019/08/14 06:00 [pubmed] PHST- 2021/08/11 06:00 [medline] PHST- 2019/08/14 06:00 [entrez] AID - 10.1089/neu.2019.6581 [doi] PST - ppublish SO - J Neurotrauma. 2020 Mar 15;37(6):839-845. doi: 10.1089/neu.2019.6581. Epub 2019 Nov 8.