Frailty among patients with adult spinal deformity associated with increased LOS, complication risk

Issue: December 2016

BOSTON — After investigators adjusted their findings for the invasiveness of surgery, severe frailty was significantly associated with increased length of hospital stay and risk of major complications among patients with adult spinal deformity.

Brian J. Neuman

“When looking at the severity of frailty, as patients became more frail, they were a higher risk of having any complication, as well as a risk of a major complication,” Brian J. Neuman, MD, said during his presentation here at the North American Spine Society Annual Meeting. “[Patients] in the severe[ly] frail group had about a 91% chance of having some sort of complication.”

Neuman and colleagues retrospectively reviewed the Scoli-Risk 1 database and identified 267 patients with at least 75% of frailty variables recorded. Investigators used the adult spinal deformity-frailty index (ASD-FI) to determine the frailty scores for all patients and classified them as not frail, frail or severely frail. Multivariable logistic regression was performed to determine associations between the ASD-FI, risk of major complications and hospital length of stay (LOS). Investigators adjusted their findings for preoperative and surgical covariates.

Results showed the mean ASD-FI score was 0.33. Neuman noted that when looking at the unadjusted odds ratio for severely frail patients, they had about a 3.5 chance for a major complication compared with patients who were not frail. Neuman said those in the severely frail group had a 3-day longer LOS compared with patients who were not frail.

“When adjusting for patient confounding factors and surgical confounding factors, you can see the severe frailty group has a 4.1-times greater chance of having a major complication,” he said. “As also seen with the LOS, you can see the severe frailty group has about an 18.9% increased risk of having increased LOS.” – by Monica Jaramillo

Reference:

Neuman BJ, et al. Paper #22. Presented at: North American Spine Society Annual Meeting; Oct. 26-29, 2016; Boston.

Disclosure: Neuman reports he receives grants from DePuy Synthes.