Key result
Frailty is linked to ~10% lower 3-month survival after lumbar spine surgery in octogenarians, without long-term impact.
Why the study?
Although positive surgical outcomes have been reported after spine surgery in the elderly, the influence of frailty on short- and long-term mortality in octogenarians after lumbar surgery remained to be investigated.
Does frailty affect short and long-term mortality in octogenarians after lumbar spine surgery?
Cohort (n=162)
No
Does frailty affect short and long-term mortality in octogenarians after lumbar spine surgery?
In octogenarians undergoing lumbar spine surgery, frailty is associated with increased short-term (3-month) mortality but does not significantly impact long-term survival.
Frailty may elevate short-term mortality risk after lumbar surgery in octogenarians; leaves open whether preoperative frailty assessment should inform decisions.
OBJECTIVE: Many studies have reported positive surgical outcomes and decreased mortality after spine surgery in the elderly population, including patients between 85 and 90 years of age. Here, in addition to patient age, we investigated the influence of frailty on short and long-term mortality in octogenarians after lumbar surgery. METHODS: We performed a retrospective analysis of 162 patients over 80 years of age who underwent posterior lumbar fusion or decompressive laminectomy between January 2011 and September 2016. We examined patient survival and modified frailty index (mFI) from medical records. RESULTS: By October 2019, 29 of 162 patients had expired (follow-up period: 1-105 months). Three-month mortality was 1.9%, and 1-year mortality was 4.9%. Frailty did not affect long-term survival at 1 year but was associated with 3-month mortality (p = 0.024). CONCLUSION: There was no relationship in long-term survival according to frailty in patients 80 years of age or older, but a difference was identified in short-term mortality. When making a surgical decision for lumbar spine surgery in frail patients over 80 years of age, surgeons should pay attention to the short-term prognosis.
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Jang et al. (2021) conducted a cohort in Lumbar spinal stenosis (n=162). Frailty vs. Robust or prefrail status was evaluated on 3-month survival (p=0.024). Frailty in patients 80 years of age or older undergoing lumbar spine surgery was associated with significantly lower 3-month survival compared to robust patients, but did not affect long-term survival.
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