Evidence map›Paper›PMID 33137985›Full record

ArticleJournal of clinical medicine2020

Frailty Is a Better Predictor than Age of Mortality and Perioperative Complications after Surgery for Degenerative Cervical Myelopathy: An Analysis of 41,369 Patients from the NSQIP Database 2010-2018.

Jamie R F Wilson, Jetan H Badhiwala, Ali Moghaddamjou, Albert Yee, Jefferson R Wilson, Michael G Fehlings

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of clinical medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 43 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
43citing papers in PubMed, 4 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

43 citing papers in PubMed, 4 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Article
  6. Article
  7. Predictive value of the risk analysis index for 30-day mortality following surgical management of thoracolumbar vertebral body fractures.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026
    Article
  8. Article
  9. Article
  10. Risk Analysis Index Outperforms the Modified Frailty Index in Predicting Outcomes in Thyroidectomy and Parathyroidectomy.Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery · 2026
    Article
  11. Article
  12. Article
  13. Article
  14. Article
  15. Article
  16. Article
  17. Article
  18. Article
  19. Article
  20. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Jamie R F WilsonNebraska Medical Center, University of Nebraska Medical Center, Omaha, NE 68198, USA.ORCID 0000-0002-3488-7506
Jetan H BadhiwalaSpine Program, Department of Surgery, University of Toronto, Toronto, ON M5T 2S8, Canada.
Ali MoghaddamjouSpine Program, Department of Surgery, University of Toronto, Toronto, ON M5T 2S8, Canada.
Albert YeeSpine Program, Department of Surgery, University of Toronto, Toronto, ON M5T 2S8, Canada.
Jefferson R WilsonSpine Program, Department of Surgery, University of Toronto, Toronto, ON M5T 2S8, Canada.
Michael G FehlingsSpine Program, Department of Surgery, University of Toronto, Toronto, ON M5T 2S8, Canada.ORCID 0000-0002-5722-6364

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe ability of frailty compared to age alone to predict adverse events in the surgical management of Degenerative Cervical Myelopathy (DCM) has not been defined in the literature.

methods41,369 patients with a diagnosis of DCM undergoing surgery were collected from the National Surgical Quality Improvement Program (NSQIP) Database 2010-2018. Univariate analysis for each measure of frailty (modified frailty index 11- and 5-point; MFI-11, MFI-5), modified Charlson Co-morbidity index and ASA grade) were calculated for the following outcomes: mortality, major complication, unplanned reoperation, unplanned readmission, length of hospital stay, and discharge to a non-home destination. Multivariable modeling of age and frailty with a base model was performed to define the discriminative ability of each measure.

resultsAge and frailty have a significant effect on all outcomes, but the MFI-5 has the largest effect size. Increasing frailty correlated significantly with the risk of perioperative adverse events, longer hospital stay, and risk of a non-home discharge destination. Multivariable modeling incorporating MFI-5 with age and the base model had a robust predictive value (0.85). MFI-5 had a high categorical assessment correlation with a MFI-11 of 0.988 ( CONCLUSIONS AND RELEVANCE: Measures of frailty have a greater effect size and a higher discriminative value to predict adverse events than age alone. MFI-5 categorical assessment is essentially equivalent to the MFI-11 score for DCM patients. A multivariable model using MFI-5 provides an accurate predictive tool that has important clinical applications.

Indexed as

agecomplicationsdegenerative cervical myelopathyfrailtymortality

Identifiers

PMID33137985
PMCPMC7692707

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.