AI Article Synopsis
- The study investigates the role of "frailty" as a predictor for non-home discharge (NHD) in patients undergoing anterior lumbar interbody fusion (ALIF) surgeries.
- The analysis utilized data from over 25,000 patients and compared two indices of frailty, the Modified Frailty Index (mFI-5) and the Revised Risk Analysis Index (RAI-rev), finding that increased frailty significantly correlates with higher NHD risk.
- Results indicated that the RAI-rev outperformed the mFI-5 in predicting NHD, suggesting its value in preoperative assessments for neurosurgery.
Article Abstract
Background: Anterior lumbar interbody fusion (ALIF) is a well-established surgical approach in the treatment of degenerative pathology, trauma, infection, and neoplasia of the spine. This study sought to assess the usefulness of frailty as a predictor of non-home discharge (NHD) for patients who undergo the procedure.
Methods: Patient cases were extracted from the American College of Surgeons's National Surgical Quality Improvement Program database from 2012 to 2020. Univariable and receiver operating characteristic curve analyses were used to compare the 5-item Modified Frailty Index (mFI-5) to the Revised Risk Analysis Index (RAI-rev) in relation to NHD.
Results: Simple linear regression demonstrated that increasing frailty was associated with an increased likelihood of NHD among 25,317 patients (mFI-5 odds ratio: 2.13, 3.23, 8.4; RAI-rev odds ratio: 3.22, 9.6, 23.6 [P<0.001 for all]). In each instance, a Cochran-Armitage trend test was significant (P<0.001), indicating a linear association of increasing odds. The RAI-rev resulted in a C-statistic of 0.722, compared to 0.628 for the mFI-5, and was shown to have superior discriminative ability with a DeLong Test (P<0.001).
Conclusions: Frailty, as measured by mFI-5 and RAI-rev, was associated with an increased likelihood of NHD in patients who underwent ALIF. This finding supports recent literature on the promising utility of these indices, especially the RAI-rev, in preoperative decision-making across multiple facets of neurosurgery.
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| http://dx.doi.org/10.23736/S0390-5616.24.06179-4 | DOI Listing |
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