Daniel B C Reid1, Alan H Daniels2, Tamir Ailon3, Emily Miller4, Daniel M Sciubba4, Justin S Smith5, Christopher I Shaffrey5, Frank Schwab6, Douglas Burton7, Robert A Hart8, Richard Hostin9, Breton Line10, Shay Bess10, Christopher P Ames11. 1. Department of Orthopedics, Brown University, Warren Alpert Medical School, Providence, Rhode Island, USA. Electronic address: danreid123@gmail.com. 2. Department of Orthopedics, Brown University, Warren Alpert Medical School, Providence, Rhode Island, USA. 3. Department of Neurosurgery, University of British Columbia, Vancouver, British Columbia, Canada. 4. Department of Neurosurgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. 5. Department of Neurological Surgery, University of Virginia, Charlottesville, Virginia, USA. 6. Department of Orthopedics, Hospital for Special Surgery, New York, New York, USA. 7. Department of Orthopedics, University of Kansas Medical Center, Kansas City, Kansas, USA. 8. Swedish Neuroscience Institute, Swedish Medical Center, Seattle, Washington, USA. 9. Baylor Scoliosis Center, Plano, Texas, USA. 10. Denver International Spine Center, Presbyterian/St. Luke's Medical Center and Rocky Mountain Hospital for Children, Denver, Colorado, USA. 11. Department of Neurologic Surgery, University of California, San Francisco, San Francisco, California, USA.
Abstract
BACKGROUND: Although the Adult Spinal Deformity Frailty Index (ASD-FI) predicts major complications and prolonged hospital length of stay after adult spinal deformity surgery, the impact of frailty on postoperative changes in health-related quality of life (HRQoL) is unknown. METHODS: Patients who underwent instrumented fusion of ≥4 levels for adult spinal deformity with minimum 2-year follow-up were stratified by Adult Spinal Deformity Frailty Index score into 3 groups: nonfrail, frail, and severely frail. Baseline and follow-up demographics, HRQoL measures, and radiographic parameters were analyzed. Primary outcome measures included proportion of patients who achieved substantial clinical benefit (SCB) in terms of Oswestry Disability Index, 36-Item Short Form Health Survey Physical Component Summary, and numeric back and leg pain scores. RESULTS: Inclusion criteria were met by 332 patients (135 nonfrail, 175 frail, 22 severely frail). Frail and severely frail patients were older and had more comorbidities, worse baseline HRQoL and pain scores, and worse radiographic deformity than nonfrail patients (P < 0.05). At 2-year follow-up, all outcome scores were worse in frail and severely frail patients compared with nonfrail patients. Frail patients improved more than nonfrail patients and were more likely to reach SCB for Oswestry Disability Index (43.7% vs. 29.3%; P = 0.025), 36-Item Short Form Health Survey Physical Component Summary (56.9% vs. 51.2%; P = 0.03), and leg pain (45.8% vs. 23.0%; P = 0.03) scores, but not back pain (57.5% vs. 63.4%; P = 0.045) score. CONCLUSIONS: Despite higher risk stratification and worse baseline HRQoL, frail patients were more likely to reach SCB for most HRQoL measures compared with nonfrail patients. Severely frail patients were the least likely to reach SCB for most HRQoL measures.
BACKGROUND: Although the Adult Spinal Deformity Frailty Index (ASD-FI) predicts major complications and prolonged hospital length of stay after adult spinal deformity surgery, the impact of frailty on postoperative changes in health-related quality of life (HRQoL) is unknown. METHODS:Patients who underwent instrumented fusion of ≥4 levels for adult spinal deformity with minimum 2-year follow-up were stratified by Adult Spinal Deformity Frailty Index score into 3 groups: nonfrail, frail, and severely frail. Baseline and follow-up demographics, HRQoL measures, and radiographic parameters were analyzed. Primary outcome measures included proportion of patients who achieved substantial clinical benefit (SCB) in terms of Oswestry Disability Index, 36-Item Short Form Health Survey Physical Component Summary, and numeric back and leg pain scores. RESULTS: Inclusion criteria were met by 332 patients (135 nonfrail, 175 frail, 22 severely frail). Frail and severely frail patients were older and had more comorbidities, worse baseline HRQoL and pain scores, and worse radiographic deformity than nonfrail patients (P < 0.05). At 2-year follow-up, all outcome scores were worse in frail and severely frail patients compared with nonfrail patients. Frail patients improved more than nonfrail patients and were more likely to reach SCB for Oswestry Disability Index (43.7% vs. 29.3%; P = 0.025), 36-Item Short Form Health Survey Physical Component Summary (56.9% vs. 51.2%; P = 0.03), and leg pain (45.8% vs. 23.0%; P = 0.03) scores, but not back pain (57.5% vs. 63.4%; P = 0.045) score. CONCLUSIONS: Despite higher risk stratification and worse baseline HRQoL, frail patients were more likely to reach SCB for most HRQoL measures compared with nonfrail patients. Severely frail patients were the least likely to reach SCB for most HRQoL measures.
Authors: Jamie R F Wilson; Jetan H Badhiwala; Fan Jiang; Jefferson R Wilson; Branko Kopjar; Alexander R Vaccaro; Michael G Fehlings Journal: J Clin Med Date: 2019-10-17 Impact factor: 4.241
Authors: Basma Mohamed; Ramani Ramachandran; Ferenc Rabai; Catherine C Price; Adam Polifka; Daniel Hoh; Christoph N Seubert Journal: J Neurosurg Anesthesiol Date: 2021-08-05 Impact factor: 3.956
Authors: Kenny Yat Hong Kwan; Lawrence G Lenke; Christopher I Shaffrey; Leah Y Carreon; Benny T Dahl; Michael G Fehlings; Christopher P Ames; Oheneba Boachie-Adjei; Mark B Dekutoski; Khaled M Kebaish; Stephen J Lewis; Yukihiro Matsuyama; Hossein Mehdian; Yong Qiu; Frank J Schwab; Kenneth Man Chee Cheung Journal: Clin Orthop Relat Res Date: 2021-02-01 Impact factor: 4.755