PMID- 34359047
OWN - NLM
STAT- Publisher
LR  - 20240220
IS  - 1547-5646 (Electronic)
IS  - 1547-5646 (Linking)
DP  - 2021 Aug 6
TI  - The impact of frailty on patient-reported outcomes after elective thoracolumbar 
      degenerative spine surgery.
PG  - 1-9
LID - 2021.2.SPINE201879 [pii]
LID - 10.3171/2021.2.SPINE201879 [doi]
AB  - OBJECTIVE: Frailty has been shown to be a risk factor of perioperative adverse 
      events (AEs) in patients undergoing various types of spine surgery. However, the 
      relationship between frailty and patient-reported outcomes (PROs) remains 
      unclear. The primary objective of this study was to determine the impact of 
      frailty on PROs of patients who underwent surgery for thoracolumbar degenerative 
      conditions. The secondary objective was to determine the associations among 
      frailty, baseline PROs, and perioperative AEs. METHODS: This was a retrospective 
      study of a prospective cohort of patients older than 55 years who underwent 
      surgery between 2012 and 2018. Data and PROs (collected with EQ-5D, Physical 
      Component Summary [PCS] and Mental Component Summary [MCS] of SF-12, Oswestry 
      Disability Index [ODI], and numeric rating scales [NRS] for back pain and leg 
      pain) of patients treated at a single academic center were extracted from the 
      Canadian Spine Outcomes and Research Network registry. Frailty was calculated 
      using the modified frailty index (mFI), and patients were classified as frail, 
      prefrail, and nonfrail. A generalized estimating equation (GEE) regression model 
      was used to assess the association between baseline frailty status and PRO 
      measures at 3 and 12 months. RESULTS: In total, 293 patients with a mean +/- SD age 
      of 67 +/- 7 years were included. Of these, 22% (n = 65) were frail, 59% (n = 172) 
      were prefrail, and 19% (n = 56) were nonfrail. At baseline, the three frailty 
      groups had similar PROs, except PCS (p = 0.003) and ODI (p = 0.02) were worse in 
      the frail group. A greater proportion of frail patients experienced major AEs 
      than nonfrail patients (p < 0.0001). However, despite the increased incidence of 
      AEs, there was no association between frailty and postoperative PROs (scores on 
      EQ-5D, PCS and MCS, ODI, and back-pain and leg-pain NRS) at 3 and 12 months (p >/= 
      0.05). In general, PROs improved at 3 and 12 months (with most patients reaching 
      the minimum clinically important difference for all PROs). CONCLUSIONS: Although 
      frailty predicted postoperative AEs, mFI did not predict PROs of patients older 
      than 55 years with degenerative thoracolumbar spine after spine surgery.
FAU - Beauchamp-Chalifour, Philippe
AU  - Beauchamp-Chalifour P
AD  - 1Department of Orthopaedic Surgery, Laval University, Quebec, Quebec.
FAU - Flexman, Alana M
AU  - Flexman AM
AD  - 2Department of Anesthesiology, Pharmacology and Therapeutics, University of 
      British Columbia, Vancouver, British Columbia; and.
FAU - Street, John T
AU  - Street JT
AD  - 3Combined Neurosurgical and Orthopaedic Spine Program, Department of Orthopaedic 
      Surgery, University of British Columbia, Vancouver, British Columbia, Canada.
FAU - Fisher, Charles G
AU  - Fisher CG
AD  - 3Combined Neurosurgical and Orthopaedic Spine Program, Department of Orthopaedic 
      Surgery, University of British Columbia, Vancouver, British Columbia, Canada.
FAU - Ailon, Tamir
AU  - Ailon T
AD  - 3Combined Neurosurgical and Orthopaedic Spine Program, Department of Orthopaedic 
      Surgery, University of British Columbia, Vancouver, British Columbia, Canada.
FAU - Dvorak, Marcel F
AU  - Dvorak MF
AD  - 3Combined Neurosurgical and Orthopaedic Spine Program, Department of Orthopaedic 
      Surgery, University of British Columbia, Vancouver, British Columbia, Canada.
FAU - Kwon, Brian K
AU  - Kwon BK
AD  - 3Combined Neurosurgical and Orthopaedic Spine Program, Department of Orthopaedic 
      Surgery, University of British Columbia, Vancouver, British Columbia, Canada.
FAU - Paquette, Scott J
AU  - Paquette SJ
AD  - 3Combined Neurosurgical and Orthopaedic Spine Program, Department of Orthopaedic 
      Surgery, University of British Columbia, Vancouver, British Columbia, Canada.
FAU - Dea, Nicolas
AU  - Dea N
AD  - 3Combined Neurosurgical and Orthopaedic Spine Program, Department of Orthopaedic 
      Surgery, University of British Columbia, Vancouver, British Columbia, Canada.
FAU - Charest-Morin, Raphaele
AU  - Charest-Morin R
AD  - 3Combined Neurosurgical and Orthopaedic Spine Program, Department of Orthopaedic 
      Surgery, University of British Columbia, Vancouver, British Columbia, Canada.
LA  - eng
PT  - Journal Article
DEP - 20210806
PL  - United States
TA  - J Neurosurg Spine
JT  - Journal of neurosurgery. Spine
JID - 101223545
SB  - IM
OTO - NOTNLM
OT  - degenerative spine population
OT  - health-related quality of life
OT  - mFI
OT  - modified frailty index
OT  - patient-reported outcomes
EDAT- 2021/08/07 06:00
MHDA- 2021/08/07 06:00
CRDT- 2021/08/06 20:29
PHST- 2020/10/20 00:00 [received]
PHST- 2021/02/02 00:00 [accepted]
PHST- 2021/08/06 20:29 [entrez]
PHST- 2021/08/07 06:00 [pubmed]
PHST- 2021/08/07 06:00 [medline]
AID - 2021.2.SPINE201879 [pii]
AID - 10.3171/2021.2.SPINE201879 [doi]
PST - aheadofprint
SO  - J Neurosurg Spine. 2021 Aug 6:1-9. doi: 10.3171/2021.2.SPINE201879.