Evidence map›Paper›PMID 37971536›Full record

Observational studyEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2024

Changes in frailty among patients hospitalized for spine pathologies during the COVID-19 pandemic in Germany-a nationwide observational study.

Julius Dengler, Hussain Gheewala, Clayton N Kraft, Aldemar A Hegewald, Ralf Dörre, Oliver Heese, Rüdiger Gerlach, Steffen Rosahl, Bernd Maier, Ralf Burger and 13 more

Abstract readObservational Study
PubMed Publisher
In one paragraph

Observational study 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, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
1.1field-weighted citation impact, top 23% of its field
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

5 citing papers in PubMed, 6 citations in OpenAlex.

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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

23 authors at 12 institutions in 1 country.

Julius DenglerFaculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, Campus Bad Saarow, Bad Saarow, Germany. julius.dengler@helios-gesundheit.de.ORCID 0000-0002-6698-8600
Hussain GheewalaFaculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, Campus Bad Saarow, Bad Saarow, Germany.
Clayton N KraftDepartment of Orthopedics, Trauma Surgery and Hand Unit, HELIOS Klinikum Krefeld, Krefeld, Germany.
Aldemar A HegewaldDepartment of Neurosurgery, VAMED Ostsee Hospital Damp, Ostseebad Damp, Germany.
Ralf DörreDepartment of Neurosurgery, HELIOS Hospital St. Marienberg, Helmstedt, Germany.
Oliver HeeseDepartment of Neurosurgery and Spinal Surgery, HELIOS Hospital Schwerin - University Campus of MSH Medical School Hamburg, Schwerin, Germany.
Rüdiger GerlachDepartment of Neurosurgery, HELIOS Hospital Erfurt, Erfurt, Germany.
Steffen RosahlDepartment of Neurosurgery, HELIOS Hospital Erfurt, Erfurt, Germany.
Bernd MaierDepartment of Trauma and Orthopedic Surgery, HELIOS Hospital Pforzheim, Pforzheim, Germany.
Ralf BurgerDepartment of Neurosurgery, HELIOS Hospital Uelzen, Uelzen, Germany.
Sebastian WutzlerDepartment of Trauma, Hand and Orthopedic Surgery, HELIOS Dr. Horst Schmidt Kliniken Wiesbaden, Wiesbaden, Germany.
Barbara CarlDepartment of Neurosurgery, University of Marburg, Marburg, Germany.
Yu-Mi RyangDepartment of Neurosurgery and Spine Center, HELIOS Hospital Berlin Buch, Berlin, Germany.
Khanh Toan HauDepartment of Spine Surgery, HELIOS Hospital Duisburg, Duisburg, Germany.
Gregor SteinDepartment of Orthopaedic, Trauma and Spine Surgery, HELIOS Hospital Siegburg, Siegburg, Germany.
Jens GulowDepartment of Spine Surgery, HELIOS Park-Klinikum Leipzig, Leipzig, Germany.
Ali AllamFaculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, Campus Bad Saarow, Bad Saarow, Germany.
Nehad AbduljawwadFaculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, Campus Bad Saarow, Bad Saarow, Germany.
Gerardo Rico GonzalezFaculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, Campus Bad Saarow, Bad Saarow, Germany.
Ralf KuhlenHELIOS Health GmbH, Berlin, Germany.
Sven HohensteinReal World Evidence and Health Technology Assessment, Helios Health Institute, Berlin, Germany.
Andreas BollmannReal World Evidence and Health Technology Assessment, Helios Health Institute, Berlin, Germany.
Michael StoffelDepartment of Neurosurgery, HELIOS Hospital Krefeld, Krefeld, Germany.
Helios Hospital Bad Saarow · DEHelios Klinikum Erfurt · DEHelios Klinikum Krefeld · DEHelios Dr. Horst Schmidt Kliniken Wiesbaden · DEHelios Hospital Berlin-Buch · DEHelios Hospital Schwerin · DEHelios Hospital Siegburg · DEHelios Park-Klinikum Leipzig · DELeipzig Heart Institute · DEMSH Medical School Hamburg – University of Applied Sciences and Medical University · DEPhilipps University of Marburg · DETUM Klinikum · DE

Funding

Helios Center for Research and Innovation HCRI ID 2021-0431
6 · The paper itself

Abstract

purposeIn spine care, frailty is associated with poor outcomes. The aim of this study was to describe changes in frailty in spine care during the coronavirus disease 2019 (COVID-19) pandemic and their relation to surgical management and outcomes.

methodsPatients hospitalized for spine pathologies between January 1, 2019, and May 17, 2022, within a nationwide network of 76 hospitals in Germany were retrospectively included. Patient frailty, types of surgery, and in-hospital mortality rates were compared between pandemic and pre-pandemic periods.

resultsOf the 223,418 included patients with spine pathologies, 151,766 were admitted during the pandemic and 71,652 during corresponding pre-pandemic periods in 2019. During the pandemic, the proportion of high-frailty patients increased from a range of 5.1-6.1% to 6.5-8.8% (p < 0.01), while the proportion of low frailty patients decreased from a range of 70.5-71.4% to 65.5-70.1% (p < 0.01). In most phases of the pandemic, the Elixhauser comorbidity index (ECI) showed larger increases among high compared to low frailty patients (by 0.2-1.8 vs. 0.2-0.8 [p < 0.01]). Changes in rates of spine surgery were associated with frailty, most clearly in rates of spine fusion, showing consistent increases among low frailty patients (by 2.2-2.5%) versus decreases (by 0.3-0.8%) among high-frailty patients (p < 0.02). Changes in rates of in-hospital mortality were not associated with frailty.

conclusionsDuring the COVID-19 pandemic, the proportion of high-frailty patients increased among those hospitalized for spine pathologies in Germany. Low frailty was associated with a rise in rates of spine surgery and high frailty with comparably larger increases in rates of comorbidities.

Indexed as

COVID-19FrailtyGermanyHumansPandemicsRetrospective StudiesCOVID-19Degenerative spine diseaseFrailtyHospital Frailty Risk ScoreMortality ratesSARS-CoV-2

Identifiers

PMID37971536
OpenAlexW4388726780

What OpenQuestion holds

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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.