Modified frailty index
The modified frailty index (mFI) can be used to evaluate the risk of both morbidity and mortality in patients.
The Charlson comorbidity index demonstrated superior predictive capacity compared to Modified frailty index and ASA scores and may be valuable as a preoperative risk assessment tool for patients undergoing spinal tumor surgery. The validation of assessment scores is important for preoperative risk stratification and improving outcomes in this high-risk group 1).
A total of 240 patients with 248 spontaneous intracerebral hemorrhages were included in a analysis. In this study, mFI was not predictive of overall mortality (p = 0.12). To further investigate this issue, patients with ICH scores of 2 or 3 were separately analyzed to assess the impact of mFI on moderate ICH cases. However, mFI was also not associated with increased hospital mortality in moderate ICH cases (p = 0.812). In bivariate Spearman analysis, mFI significantly correlated with several outcome measures including the modified Rankin Scale (MRS) at discharge (p = 0.01), but ICH score also correlated with these outcomes (p < 0.001). Although ICH & mFI scores were both predictive of MRS with linear regression, multivariate demonstrated that the ICH score was the only independent risk factor for MRS (p = 0.698, p < 0.001 respectively).
Frailty, as measured by the mFI, was not an independent risk factor for increased mortality or worse outcomes in SICH patients. This study does not support incorporating the mFI score for SICH patients for prognostication 2).
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2: Zuckerman SL, Mummareddy N, Lakomkin N, Sivaganesan A, Asher A, Devin CJ. Identifying the Most Appropriate ACDF Patients for an Ambulatory Surgery Center: A Pilot Study Using Inpatient and Outpatient Hospital Data. Clin Spine Surg. 2020 Mar 31. doi: 10.1097/BSD.0000000000000967. [Epub ahead of print] PubMed PMID: 32235168.
3: Tan T, Huang MS, Hunn MK, Tee J. Patients with ankylosing spondylitis suffering from AO Type B3 traumatic thoracolumbar fractures are associated with increased frailty and morbidity when compared with patients with diffuse idiopathic skeletal hyperostosis. J Spine Surg. 2019 Dec;5(4):425-432. doi: 10.21037/jss.2019.09.11. PubMed PMID: 32042992; PubMed Central PMCID: PMC6989928.
4: McIntyre MK, Gandhi C, Long A, Van Hoof A, Li B, Patel V, Afridi A, Halabi M, Schmidt M, Cole C, Santarelli J, Al-Mufti F, Bowers CA. Age predicts outcomes better than frailty following aneurysmal subarachnoid hemorrhage: A retrospective cohort analysis. Clin Neurol Neurosurg. 2019 Dec;187:105558. doi: 10.1016/j.clineuro.2019.105558. Epub 2019 Oct 11. PubMed PMID: 31704388.
5: McIntyre M, Gandhi C, Dragonette J, Schmidt M, Cole C, Santarelli J, Lehrer R, Al-Mufti F, Bowers CA. Increasing Frailty Predicts Worse Outcomes and Increased Complications After Angiogram-Negative Subarachnoid Hemorrhages. World Neurosurg. 2020 Feb;134:e181-e188. doi: 10.1016/j.wneu.2019.10.003. Epub 2019 Oct 9. PubMed PMID: 31605860.
6: Banaszek D, Inglis T, Marion TE, Charest-Morin R, Moskven E, Rivers CS, Kurban D, Flexman AM, Ailon T, Dea N, Kwon BK, Paquette S, Fisher CG, Dvorak MF, Street JT. Effect of Frailty on Outcome after Traumatic Spinal Cord Injury. J Neurotrauma. 2020 Mar 15;37(6):839-845. doi: 10.1089/neu.2019.6581. Epub 2019 Nov 8. PubMed PMID: 31407621.
8: Richardson AM, McCarthy DJ, Sandhu J, Mayrand R, Guerrero C, Rosenberg C, Gernsback JE, Komotar R, Ivan M. Predictors of Successful Discharge of Patients on Postoperative Day 1 After Craniotomy for Brain Tumor. World Neurosurg. 2019 Jun;126:e869-e877. doi: 10.1016/j.wneu.2019.03.004. Epub 2019 Mar 9. PubMed PMID: 30862575.
9: Ota N, Noda K, Hatano Y, Hashimoto A, Miyazaki T, Kondo T, Kinoshita Y, Kamiyama H, Tokuda S, Kamada K, Tanikawa R. Preoperative Predictors and Prognosticators After Microsurgical Clipping of Poor-Grade Subarachnoid Hemorrhage: A Retrospective Study. World Neurosurg. 2019 May;125:e582-e592. doi: 10.1016/j.wneu.2019.01.135. Epub 2019 Feb 2. PubMed PMID: 30716502.
11: Imaoka Y, Kawano T, Hashiguchi A, Fujimoto K, Yamamoto K, Nishi T, Otsuka T, Yano S, Mukasa A. Modified frailty index predicts postoperative outcomes of spontaneous intracerebral hemorrhage. Clin Neurol Neurosurg. 2018 Dec;175:137-143. doi: 10.1016/j.clineuro.2018.11.004. Epub 2018 Nov 5. PubMed PMID: 30445342.
12: Gong W, Qi X. Association of Frailty with Delayed Recovery of Gastrointestinal Function after Elective Colorectal Cancer Resections. J Invest Surg. 2018 Nov 15:1-7. doi: 10.1080/08941939.2018.1524528. [Epub ahead of print] PubMed PMID: 30430890.
13: Passias PG, Bortz CA, Pierce KE, Segreto FA, Horn SR, Vasquez-Montes D, Lafage V, Brown AE, Ihejirika Y, Alas H, Varlotta C, Ge DH, Shepard N, Oh C, DelSole EM, Jankowski PP, Hockley A, Diebo BG, Vira SN, Sciubba DM, Raad M, Neuman BJ, Gerling MC. Decreased rates of 30-day perioperative complications following ASD-corrective surgery: A modified Clavien analysis of 3300 patients from 2010 to 2014. J Clin Neurosci. 2019 Mar;61:147-152. doi: 10.1016/j.jocn.2018.10.104. Epub 2018 Nov 10. PubMed PMID: 30424970.
14: Segreto FA, Lafage V, Lafage R, Smith JS, Line BG, Eastlack RK, Scheer JK, Chou D, Frangella NJ, Horn SR, Bortz CA, Diebo BG, Neuman BJ, Protopsaltis TS, Kim HJ, Klineberg EO, Burton DC, Hart RA, Schwab FJ, Bess S, Shaffrey CI, Ames CP, Passias PG. Recovery Kinetics: Comparison of Patients Undergoing Primary or Revision Procedures for Adult Cervical Deformity Using a Novel Area Under the Curve Methodology. Neurosurgery. 2019 Jul 1;85(1):E40-E51. doi: 10.1093/neuros/nyy435. PubMed PMID: 30272188.
15: Passias PG, Bortz CA, Segreto FA, Horn SR, Lafage R, Lafage V, Smith JS, Line B, Kim HJ, Eastlack R, Hamilton DK, Protopsaltis T, Hostin RA Jr, Klineberg EO, Burton DC, Hart RA, Schwab FJ, Bess S, Shaffrey CI, Ames CP; International Spine Study Group. Development of a Modified Cervical Deformity Frailty Index: A Streamlined Clinical Tool for Preoperative Risk Stratification. Spine (Phila Pa 1976). 2019 Feb 1;44(3):169-176. doi: 10.1097/BRS.0000000000002778. PubMed PMID: 30005037.
16: Raghavan G, Shaverdian N, Chan S, Chu FI, Lee P. Comparing Outcomes of Patients With Early-Stage Non-Small-Cell Lung Cancer Treated With Stereotactic Body Radiotherapy Based on Frailty Status. Clin Lung Cancer. 2018 Sep;19(5):e759-e766. doi: 10.1016/j.cllc.2018.05.008. Epub 2018 Jun 6. PubMed PMID: 29954680.
17: Evans LR, Jones J, Lee HQ, Gantner D, Jaison A, Matthew J, Fitzgerald MC, Rosenfeld JV, Hunn MK, Tee JW. Prognosis of Acute Subdural Hematoma in the Elderly: A Systematic Review. J Neurotrauma. 2019 Feb 15;36(4):517-522. doi: 10.1089/neu.2018.5829. Epub 2018 Aug 14. PubMed PMID: 29943683.
18: Shimizu K, Sadatomo T, Hara T, Onishi S, Yuki K, Kurisu K. Importance of frailty evaluation in the prediction of the prognosis of patients with chronic subdural hematoma. Geriatr Gerontol Int. 2018 Aug;18(8):1173-1176. doi: 10.1111/ggi.13436. Epub 2018 May 17. PubMed PMID: 29770549.
19: Kessler RA, De la Garza Ramos R, Purvis TE, Ahmed AK, Goodwin CR, Sciubba DM, Abd-El-Barr MM. Impact of frailty on complications in patients with thoracic and thoracolumbar spinal fracture. Clin Neurol Neurosurg. 2018 Jun;169:161-165. doi: 10.1016/j.clineuro.2018.04.014. Epub 2018 Apr 9. PubMed PMID: 29702425.
20: Youngerman BE, Neugut AI, Yang J, Hershman DL, Wright JD, Bruce JN. The modified frailty index and 30-day adverse events in oncologic neurosurgery. J Neurooncol. 2018 Jan;136(1):197-206. doi: 10.1007/s11060-017-2644-0. Epub 2017 Nov 14. PubMed PMID: 29139096.
21: Franco I, Chen YH, Chipidza F, Agrawal V, Romano J, Baldini E, Chen A, Colson Y, Hou Y, Kozono D, Wee J, Mak R. Use of frailty to predict survival in elderly patients with early stage non-small-cell lung cancer treated with stereotactic body radiation therapy. J Geriatr Oncol. 2018 Mar;9(2):130-137. doi: 10.1016/j.jgo.2017.09.002. Epub 2017 Sep 21. PubMed PMID: 28941581.
22: Esses G, Andreopoulos E, Lin HM, Arya S, Deiner S. A Comparison of Three Frailty Indices in Predicting Morbidity and Mortality After On-Pump Aortic Valve Replacement. Anesth Analg. 2018 Jan;126(1):39-45. doi: 10.1213/ANE.0000000000002411. PubMed PMID: 28857797; PubMed Central PMCID: PMC6457243.
23: Charest-Morin R, Street J, Zhang H, Roughead T, Ailon T, Boyd M, Dvorak M, Kwon B, Paquette S, Dea N, Fisher CG, Flexman AM. Frailty and sarcopenia do not predict adverse events in an elderly population undergoing non-complex primary elective surgery for degenerative conditions of the lumbar spine. Spine J. 2018 Feb;18(2):245-254. doi: 10.1016/j.spinee.2017.07.003. Epub 2017 Jul 12. PubMed PMID: 28709946.
24: Mori K, Wada K, Otani N, Tomiyama A, Toyooka T, Fujii K, Kumagai K, Takeuchi S, Tomura S, Yamamoto T, Nakao Y, Arai H. Validation of effectiveness of keyhole clipping in nonfrail elderly patients with unruptured intracranial aneurysms. J Neurosurg. 2017 Dec;127(6):1307-1314. doi: 10.3171/2016.9.JNS161634. Epub 2017 Jan 6. PubMed PMID: 28059648.
25: Leven DM, Lee NJ, Kothari P, Steinberger J, Guzman J, Skovrlj B, Shin JI, Caridi JM, Cho SK. Frailty Index Is a Significant Predictor of Complications and Mortality After Surgery for Adult Spinal Deformity. Spine (Phila Pa 1976). 2016 Dec 1;41(23):E1394-E1401. PubMed PMID: 27584671.
26: Flexman AM, Charest-Morin R, Stobart L, Street J, Ryerson CJ. Frailty and postoperative outcomes in patients undergoing surgery for degenerative spine disease. Spine J. 2016 Nov;16(11):1315-1323. doi: 10.1016/j.spinee.2016.06.017. Epub 2016 Jun 30. PubMed PMID: 27374110.
27: Ali R, Schwalb JM, Nerenz DR, Antoine HJ, Rubinfeld I. Use of the modified frailty index to predict 30-day morbidity and mortality from spine surgery. J Neurosurg Spine. 2016 Oct;25(4):537-541. Epub 2016 May 6. PubMed PMID: 27153143.
28: Cloney M, D'Amico R, Lebovic J, Nazarian M, Zacharia BE, Sisti MB, Bruce JN, McKhann GM, Iwamoto FM, Sonabend AM. Frailty in Geriatric Glioblastoma Patients: A Predictor of Operative Morbidity and Outcome. World Neurosurg. 2016 May;89:362-7. doi: 10.1016/j.wneu.2015.12.096. Epub 2016 Jan 14. PubMed PMID: 26775233.