Cargando…

Frailty Syndrome and the Use of Frailty Indices as a Preoperative Risk Stratification Tool in Spine Surgery: A Review

This comprehensive narrative literature review aims to extract studies related to frailty indices and their use in elective spine procedures, as limited studies regarding frailty exist in the spine literature. Most studies are retrospective analyses of prospectively collected databases. Evidence sug...

Descripción completa

Detalles Bibliográficos
Autores principales: Simcox, Trevor, Antoku, Derek, Jain, Nickul, Acosta, Frank, Hah, Raymond
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Society of Spine Surgery 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6773997/
https://www.ncbi.nlm.nih.gov/pubmed/31154707
http://dx.doi.org/10.31616/asj.2018.0239
_version_ 1783456011257905152
author Simcox, Trevor
Antoku, Derek
Jain, Nickul
Acosta, Frank
Hah, Raymond
author_facet Simcox, Trevor
Antoku, Derek
Jain, Nickul
Acosta, Frank
Hah, Raymond
author_sort Simcox, Trevor
collection PubMed
description This comprehensive narrative literature review aims to extract studies related to frailty indices and their use in elective spine procedures, as limited studies regarding frailty exist in the spine literature. Most studies are retrospective analyses of prospectively collected databases. Evidence suggests a positive correlation between frailty level and mortality rate, postoperative complication rate, length of stay, and the possibility of discharge to a skilled nursing facility; these correlations have been illustrated across various spine procedures. The leading index is the modified frailty index, which measures 11 deficits. The development of more comprehensive frailty indices, such as the Adult Spinal Deformity Frailty Index, are promising and have high predictive value regarding postoperative complication rate in patients with spinal deformity. However, a frailty index that combines clinical, radiographic, and laboratory measures awaits development. Perhaps, the use of a frailty index in preoperative risk stratification for elective spine procedures could serve multiple purposes, including screening for high-risk patients, enhancement of operative decision making, approximation of complication rate for informed decision making, and refinement of perioperative care. Further prospective studies are warranted to determine clinically meaningful interventions in frail individuals.
format Online
Article
Text
id pubmed-6773997
institution National Center for Biotechnology Information
language English
publishDate 2019
publisher Korean Society of Spine Surgery
record_format MEDLINE/PubMed
spelling pubmed-67739972019-10-09 Frailty Syndrome and the Use of Frailty Indices as a Preoperative Risk Stratification Tool in Spine Surgery: A Review Simcox, Trevor Antoku, Derek Jain, Nickul Acosta, Frank Hah, Raymond Asian Spine J Review Article This comprehensive narrative literature review aims to extract studies related to frailty indices and their use in elective spine procedures, as limited studies regarding frailty exist in the spine literature. Most studies are retrospective analyses of prospectively collected databases. Evidence suggests a positive correlation between frailty level and mortality rate, postoperative complication rate, length of stay, and the possibility of discharge to a skilled nursing facility; these correlations have been illustrated across various spine procedures. The leading index is the modified frailty index, which measures 11 deficits. The development of more comprehensive frailty indices, such as the Adult Spinal Deformity Frailty Index, are promising and have high predictive value regarding postoperative complication rate in patients with spinal deformity. However, a frailty index that combines clinical, radiographic, and laboratory measures awaits development. Perhaps, the use of a frailty index in preoperative risk stratification for elective spine procedures could serve multiple purposes, including screening for high-risk patients, enhancement of operative decision making, approximation of complication rate for informed decision making, and refinement of perioperative care. Further prospective studies are warranted to determine clinically meaningful interventions in frail individuals. Korean Society of Spine Surgery 2019-10 2019-06-03 /pmc/articles/PMC6773997/ /pubmed/31154707 http://dx.doi.org/10.31616/asj.2018.0239 Text en Copyright © 2019 by Korean Society of Spine Surgery This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review Article
Simcox, Trevor
Antoku, Derek
Jain, Nickul
Acosta, Frank
Hah, Raymond
Frailty Syndrome and the Use of Frailty Indices as a Preoperative Risk Stratification Tool in Spine Surgery: A Review
title Frailty Syndrome and the Use of Frailty Indices as a Preoperative Risk Stratification Tool in Spine Surgery: A Review
title_full Frailty Syndrome and the Use of Frailty Indices as a Preoperative Risk Stratification Tool in Spine Surgery: A Review
title_fullStr Frailty Syndrome and the Use of Frailty Indices as a Preoperative Risk Stratification Tool in Spine Surgery: A Review
title_full_unstemmed Frailty Syndrome and the Use of Frailty Indices as a Preoperative Risk Stratification Tool in Spine Surgery: A Review
title_short Frailty Syndrome and the Use of Frailty Indices as a Preoperative Risk Stratification Tool in Spine Surgery: A Review
title_sort frailty syndrome and the use of frailty indices as a preoperative risk stratification tool in spine surgery: a review
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6773997/
https://www.ncbi.nlm.nih.gov/pubmed/31154707
http://dx.doi.org/10.31616/asj.2018.0239
work_keys_str_mv AT simcoxtrevor frailtysyndromeandtheuseoffrailtyindicesasapreoperativeriskstratificationtoolinspinesurgeryareview
AT antokuderek frailtysyndromeandtheuseoffrailtyindicesasapreoperativeriskstratificationtoolinspinesurgeryareview
AT jainnickul frailtysyndromeandtheuseoffrailtyindicesasapreoperativeriskstratificationtoolinspinesurgeryareview
AT acostafrank frailtysyndromeandtheuseoffrailtyindicesasapreoperativeriskstratificationtoolinspinesurgeryareview
AT hahraymond frailtysyndromeandtheuseoffrailtyindicesasapreoperativeriskstratificationtoolinspinesurgeryareview