ArticleSpine deformity2022
Is frailty responsive to surgical correction of adult spinal deformity? An investigation of sagittal re-alignment and frailty component drivers of postoperative frailty status.
Article in Spine deformity, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed, 3 citations in OpenAlex.
- Future Data Points to Implement in Adult Spinal Deformity Assessment for Artificial Intelligence Modeling Prediction: The Importance of the Biological Dimension.International journal of spine surgery · 2023Article
- Importance of physiological age in determining indications for adult spinal deformity surgery in patients over 75 years of age: a propensity score matching analysis.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 · 2022Article
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Authors and funding
14 authors at 8 institutions in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
purposeFrailty has been associated with adverse postoperative outcomes. Recently, a novel frailty index for preoperative risk stratification in patients with adult spinal deformity was developed. Components of the ASD-FI utilize patient comorbidity, clinical symptoms, and patient-reported-outcome-measures (PROMS). Our purpose was to investigate components of the Adult Spinal Deformity Frailty Index (ASD-FI) responsive to surgery and drivers of overall frailty.
methodsOperative ASD patients ≥ 18 years, undergoing multilevel fusions, with complete baseline, 6 W, 1Y and 2Y ASD-FI scores. Descriptive analysis assessed demographics, radiographic parameters, and surgical details. Pearson bivariate correlations, independent and paired t tests assessed postoperative changes to ASD-FI components, total score, and radiographic parameters. Linear regression models determined the effect of successful surgery (achieving lowest level SRS-Schwab classification modifiers) on change in ASD-FI total scores.
results409 6-week, 696 1-year, and 253 2-year operative ASD patients were included. 6-week and 1-year baseline frailty scores were 0.34, 2 years was 0.38. Following surgery, 6-week frailty was 0.36 (p = 0.033), 1 year was 0.25 (p < 0.001), and 2 years was 0.28 (p < 0.001). Of the ASD-FI variables, 17/40 improved at 6 weeks, 21/40 at 1 year, and 18/40 at 2 years. Successful surgery significantly predicted decreases in 1-year frailty scores (R = 0.27, p < 0.001), SRS-Schwab SVA modifier was the greatest predictor (Adjusted Beta: - 0.29, p < 0.001).
conclusionsImprovement in sagittal realignment and functional status correlated with improved postoperative frailty. Additional research and deformity sub-group analyses are needed to describe associations between specific functional activities that correlated with frailty improvement as well as evaluation of modifiable and non-modifiable indices. LEVEL OF EVIDENCE: 3:
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