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- Title
External validation of the adult spinal deformity (ASD) frailty index (ASD-FI).
- Authors
The European Spine Study Group; The International Spine Study Group; European Spine Study Group; International Spine Study Group; Miller, Emily K.; Sánchez Pérez-Grueso, Francisco Javier; Carreon, Leah Y.; Schwab, Frank J.; Lafage, Virginie; Bess, Shay; Scheer, Justin K.; Ames, Christopher P.; Vila-Casademunt, Alba; Pellisé, Ferran; Neuman, Brian J.; Kebaish, Khaled M.; Sciubba, Daniel M.; Smith, Justin S.; Shaffrey, Christopher I.; Alanay, Ahmet
- Abstract
<bold>Purpose: </bold>To assess the ability of the recently developed adult spinal deformity frailty index (ASD-FI) to predict odds of perioperative complications, odds of reoperation, and length of hospital stay after adult spinal deformity (ASD) surgery using a database other than the one used to create the index.<bold>Methods: </bold>We used the ASD-FI to calculate frailty scores for 266 ASD patients who had minimum postoperative follow-up of 2 years in the European Spine Study Group (ESSG) database. Patients were enrolled from 2012 through 2013. Using ASD-FI scores, we categorized patients as not frail (NF) (< 0.3 points), frail (0.3-0.5 points), or severely frail (SF) (> 0.5 points). Multivariable logistic regression, adjusted for preoperative and surgical factors such as operative time and blood loss, was performed to determine the relationship between ASD-FI category and odds of major complications, odds of reoperation, and length of hospital stay.<bold>Results: </bold>We categorized 135 patients (51%) as NF, 90 patients (34%) as frail, and 41 patients (15%) as SF. Overall mean ASD-FI score was 0.29 (range 0-0.8). The adjusted odds of experiencing a major intraoperative or postoperative complication (OR 4.5, 95% CI 2.0-10) or having a reoperation (OR 3.9, 95% CI 1.7-8.9) were higher for SF patients compared with NF patients. Mean hospital stay was 2.1 times longer (95% CI 1.8-2.4) for SF patients compared with NF patients.<bold>Conclusions: </bold>Greater patient frailty, as measured by the ASD-FI, is associated with longer hospital stays and greater odds of major complications and reoperation. These slides can be retrieved under Electronic Supplementary Material.
- Subjects
SPINE abnormalities; SPINE physiology; BLOOD loss estimation; PREOPERATIVE care; SPINAL surgery
- Publication
European Spine Journal, 2018, Vol 27, Issue 9, p2331
- ISSN
0940-6719
- Publication type
journal article
- DOI
10.1007/s00586-018-5575-3