Evidence map›Paper›PMID 34398335›Full record

ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2021

The influence of frailty on postoperative complications in geriatric patients receiving single-level lumbar fusion surgery.

Shane Shahrestani, Andy Ton, Xiao T Chen, Alexander M Ballatori, Jeffrey C Wang, Zorica Buser

Abstract read
PubMed Publisher
In one paragraph

Article in 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, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed, 2 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

10 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Robotic versus conventional single-level lumbar fusion in frail older adults: analysis of the National Readmission Database, 2016-2020.Journal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology · 2025
    Article
  4. The use of the psoas-to-lumbar vertebrae index and modified frailty index in predicting postoperative complications in degenerative spine surgery: can sarcopenia or frailty be underestimated?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 · 2025
    Article
  5. Article
  6. Observational
  7. Article
  8. Article
  9. Article
  10. Article
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.

Shane Shahrestani *Department of Orthopaedic Surgery, Keck School of Medicine of USC, University of Southern California, 1450 San Pablo St., HC4- Suite 5400A, Los Angeles, CA, USA.
Andy Ton *Department of Orthopaedic Surgery, Keck School of Medicine of USC, University of Southern California, 1450 San Pablo St., HC4- Suite 5400A, Los Angeles, CA, USA.
Xiao T ChenDepartment of Orthopaedic Surgery, Keck School of Medicine of USC, University of Southern California, 1450 San Pablo St., HC4- Suite 5400A, Los Angeles, CA, USA.
Alexander M BallatoriDepartment of Orthopaedic Surgery, Keck School of Medicine of USC, University of Southern California, 1450 San Pablo St., HC4- Suite 5400A, Los Angeles, CA, USA.
Jeffrey C WangDepartment of Orthopaedic Surgery, Keck School of Medicine of USC, University of Southern California, 1450 San Pablo St., HC4- Suite 5400A, Los Angeles, CA, USA.
Zorica BuserDepartment of Orthopaedic Surgery, Keck School of Medicine of USC, University of Southern California, 1450 San Pablo St., HC4- Suite 5400A, Los Angeles, CA, USA. zbuser@usc.edu.ORCID 0000-0002-5680-0643

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThis study evaluates the influence of patient frailty status on postoperative complications in those receiving single-level lumbar fusion surgery.

methodsThe nationwide readmission database was retrospectively queried between 2016 and 2017 for all patients receiving single-level lumbar fusion surgery. Readmissions were analyzed at 30, 90, and 180 days from primary discharge. Demographics, frailty status, and relevant complications were queried at index admission and all readmission intervals. Complications of interest included infection, urinary tract infection (UTI), posthemorrhagic anemia, inpatient length of stay (LOS), and adjusted all-payer costs. Nearest-neighbor propensity score matching for demographics was implemented to identify non-frail control patients with similar diagnoses and procedures. The analysis used nonparametric Mann-Whitney U testing and odds ratios.

resultsComparing propensity-matched cohorts revealed significantly greater LOS and total all-payer inpatient costs in frail patients than non-frail patients with comparable demographics and comorbidities (p < 0.0001 for both). Furthermore, frail patients encountered higher rates of UTI (OR: 3.97, 95%CI: 3.21-4.95, p < 0.0001), infection (OR: 6.87, 95%CI: 4.55-10.86, p < 0.0001), and posthemorrhagic anemia (OR: 1.94, 95%CI: 1.71-2.19, p < 0.0001) immediately following surgery. Frail patients had significantly higher rates of 30-day (OR: 1.24, 95%CI: 1.02-1.51, p = 0.035), 90-day (OR: 1.38, 95%CI: 1.17-1.63, p < 0.001), and 180-day (OR: 1.55, 95%CI: 1.30-1.85, p < 0.0001) readmissions. Lastly, frail patients had higher rates of infection at 30-day (OR: 1.61, 95%CI: 1.05-2.46, p = 0.027) and 90-day (OR: 1.51, 95%CI: 1.07-2.16, p = 0.020) readmission intervals.

conclusionsPatient frailty status may serve as an important predictor of postoperative outcomes in patients receiving single-level lumbar fusion surgery.

Indexed as

FrailtyAgedHumansLength of StayLumbosacral RegionPatient ReadmissionPostoperative ComplicationsRetrospective StudiesRisk FactorsFrailtyFusionLumbarReadmissionsSingle levelSpine

Identifiers

PMID34398335

What OpenQuestion holds

Textmetadata
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.