AI Article Synopsis

  • Frailty, measured by the modified frailty index (MFI), is a better predictor of adverse surgical outcomes in patients with Degenerative Cervical Myelopathy (DCM) than age alone.
  • The study analyzed data from over 41,000 DCM patients, finding that frailty significantly increases the risk of complications, longer hospital stays, and non-home discharges post-surgery.
  • The MFI-5 index demonstrated strong predictive accuracy and is nearly equivalent to the MFI-11, suggesting it is a valuable tool for clinicians in assessing surgical risk in DCM patients.

Article Abstract

Background: The ability of frailty compared to age alone to predict adverse events in the surgical management of Degenerative Cervical Myelopathy (DCM) has not been defined in the literature.

Methods: 41,369 patients with a diagnosis of DCM undergoing surgery were collected from the National Surgical Quality Improvement Program (NSQIP) Database 2010-2018. Univariate analysis for each measure of frailty (modified frailty index 11- and 5-point; MFI-11, MFI-5), modified Charlson Co-morbidity index and ASA grade) were calculated for the following outcomes: mortality, major complication, unplanned reoperation, unplanned readmission, length of hospital stay, and discharge to a non-home destination. Multivariable modeling of age and frailty with a base model was performed to define the discriminative ability of each measure.

Results: Age and frailty have a significant effect on all outcomes, but the MFI-5 has the largest effect size. Increasing frailty correlated significantly with the risk of perioperative adverse events, longer hospital stay, and risk of a non-home discharge destination. Multivariable modeling incorporating MFI-5 with age and the base model had a robust predictive value (0.85). MFI-5 had a high categorical assessment correlation with a MFI-11 of 0.988 ( < 0.001).

Conclusions And Relevance: Measures of frailty have a greater effect size and a higher discriminative value to predict adverse events than age alone. MFI-5 categorical assessment is essentially equivalent to the MFI-11 score for DCM patients. A multivariable model using MFI-5 provides an accurate predictive tool that has important clinical applications.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7692707PMC
http://dx.doi.org/10.3390/jcm9113491DOI Listing

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