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An assessment of frailty as a tool for risk stratification in adult spinal deformity surgery

机译：脆弱作为成人脊柱畸形手术风险分层工具的评估

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OBJECTIVE The goal of this study was to analyze the value of an adult spinal deformity frailty index (ASD-FI) in preoperative risk stratification. Preoperative risk assessment is imperative before procedures known to have high complication rates, such as ASD surgery. Frailty has been associated with risk of complications in trauma surgery, and preoperative frailty assessments could improve the accuracy of risk stratification by providing a comprehensive analysis of patient factors that contribute to an increased risk of complications. METHODS Using 40 variables, the authors calculated frailty scores with a validated method for 417 patients (enrolled between 2010 and 2014) with a minimum 2-year follow-up in an ASD database. On the basis of these scores, the authors categorized patients as not frail (NF) ( 0.5 points). The correlation between frailty category and incidence of complications was analyzed. RESULTS The overall mean ASD-FI score was 0.33 (range 0.0–0.8). Compared with NF patients (n = 183), frail patients (n = 158) and SF patients (n = 109) had longer mean hospital stays (1.2 and 1.6 times longer, respectively; p CONCLUSIONS Greater patient frailty, as measured by the ASD-FI, was associated with worse outcome in many common quality and value metrics, including greater risk of major complications, proximal junctional kyphosis, pseudarthrosis, deep wound infection, wound dehiscence, reoperation, and longer hospital stay.
机译：目的本研究的目的是分析成人脊柱畸形脆弱指数（ASD-FI）在术前危险分层中的价值。在已知具有高并发症发生率的程序（例如ASD手术）之前，必须进行术前风险评估。脆弱与创伤手术中发生并发症的风险有关，术前脆弱性评估可通过对导致并发症风险增加的患者因素进行全面分析，从而提高风险分层的准确性。方法使用40个变量，作者使用ASD数据库中至少进行了2年随访的417例患者（2010年至2014年之间入组）通过验证的方法计算了脆弱评分。根据这些评分，作者将患者分类为“不虚弱（NF）”（0.5分）。分析了脆弱类别与并发症发生率之间的相关性。结果ASD-FI总体平均得分为0.33（范围为0.0-0.8）。与NF患者（n = 183）相比，体弱患者（n = 158）和SF患者（n = 109）的平均住院时间更长（分别为1.2倍和1.6倍; p）结论-FI在许多常见的质量和价值指标中与较差的预后相关，包括重大并发症，近端结节性驼背，假关节，深部伤口感染，伤口裂开，再次手术和更长的住院时间的较高风险。

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