Evidence map›Paper›PMID 37291408›Full record

ArticleSpine deformity2023

The 5-item modified frailty index predicts spinal osteotomy outcomes better than age in adult spinal deformity patients: an ACS - NSQIP analysis.

Omar H Tarawneh, John Vellek, Syed Faraz Kazim, Rachel Thommen, Katie Roster, Matthew Conlon, Daniel J Alvarez-Crespo, Kyril L Cole, Samantha Varela, Jose F Dominguez and 3 more

Abstract read
PubMed Publisher
In one paragraph

Article in Spine deformity, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 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

6 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
  3. Article
  4. Article
  5. Risk analysis index predicts mortality and non-home discharge following posterior lumbar interbody fusion: a nationwide inpatient sample analysis of 429,380 patients (2019-2020).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 · 2024
    Article
  6. 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

13 authors.

Omar H TarawnehSchool of Medicine, New York Medical College, Valhalla, NY, 10595, USA.
John VellekSchool of Medicine, New York Medical College, Valhalla, NY, 10595, USA.
Syed Faraz KazimDepartment of Neurosurgery, University of New Mexico Hospital (UNMH), Albuquerque, NM, 87131, USA.ORCID http://orcid.org/0000-0001-8723-4181
Rachel ThommenSchool of Medicine, New York Medical College, Valhalla, NY, 10595, USA.
Katie RosterSchool of Medicine, New York Medical College, Valhalla, NY, 10595, USA.
Matthew ConlonSchool of Medicine, New York Medical College, Valhalla, NY, 10595, USA.
Daniel J Alvarez-CrespoSchool of Medicine, University of Panama, Simon Bolivar Avenue, Panama, Panama, 07096, USA.
Kyril L ColeSchool of Medicine, University of Utah, Salt Lake City, UT, USA.
Samantha VarelaSchool of Medicine, University of New Mexico, Albuquerque, NM, 87131, USA.
Jose F DominguezDepartment of Neurosurgery, Westchester Medical Center and New York Medical College, Valhalla, NY, USA.
Rohini G MckeeDepartment of Surgery, University of New Mexico, Albuquerque, NM, USA.
Meic H SchmidtDepartment of Neurosurgery, University of New Mexico Hospital (UNMH), Albuquerque, NM, 87131, USA.
Christian A BowersDepartment of Neurosurgery, University of New Mexico Hospital (UNMH), Albuquerque, NM, 87131, USA. CABowers@salud.unm.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo evaluate the utility of 5-Item Modified Frailty Index (mFI-5) as compared to chronological age in predicting outcomes of spinal osteotomy in Adult Spinal Deformity (ASD) patients.

methodsUsing Current Procedural and Terminology (CPT) codes, the American College of Surgeons National Surgery Quality Improvement Program (ACS-NSQIP) database was queried for adult patients undergoing spinal osteotomy from 2015 to 2019. Multivariate regression analysis was performed to evaluate the effect of baseline frailty status, measured by mFI-5 score, and chronological age on postoperative outcomes. Receiver-operating characteristic (ROC) curve analysis was performed to analyze the discriminative performance of age versus mFI-5.

resultsA total of 1,789 spinal osteotomy patients (median age 62 years) were included in the analysis. Among the patients assessed, 38.5% (n = 689) were pre-frail, 14.6% frail (n = 262), and 2.2% (n = 39) severely frail using the mFI-5. Based on the multivariate analysis, increasing frailty tier was associated with worsening outcomes, and higher odds ratios (OR) for poor outcomes were found for increasing frailty tiers as compared to age. Severe frailty was associated with the worst outcomes, e.g., unplanned readmission (OR 9.618, [95% CI 4.054-22.818], p < 0.001) and major complications (OR 5.172, [95% CI 2.271-11.783], p < 0.001). In the ROC curve analysis, mFI-5 score (AUC 0.838) demonstrated superior discriminative performance than age (AUC 0.601) for mortality.

conclusionsThe mFI5 frailty score was found to be a better predictor than age of worse postoperative outcomes in ASD patients. Incorporating frailty in preoperative risk stratification is recommended in ASD surgery.

Indexed as

FrailtyAdultDatabases, FactualHumansMiddle AgedOsteotomyPostoperative ComplicationsQuality ImprovementAdult spinal deformityAgeFrailtyModified frailty index-5 (mFI-5)OsteotomyPostoperative outcomes

Identifiers

PMID37291408

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.