Key result
Very frail patients (RAI ≥ 46) had a 45.8-fold increased odds of failure to rescue (30-day mortality following a major complication) compared to robust patients after thoracolumbar fusion.
Why the study?
Although failure to rescue has been used as a quality-improvement metric across surgical specialties, its use in spine surgery remains limited.
Population
15,749 patients undergoing thoracolumbar fusion in NSQIP
Comparison
FTR vs non-FTR cohorts
Design
Retrospective database cohort study
Follow-up
30 days
Authors
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May aid preoperative risk stratification in thoracolumbar fusion; hypothesis-generating for frailty-targeted interventions.
Cohort (n=15,749)
Yes
Odds Ratio: 45.79 (95% CI 14.82–141.5)
p-value: p=<0.001
Baseline frailty, as measured by the Risk Analysis Index, accurately predicts 30-day mortality following a major complication in patients undergoing thoracolumbar fusion.
Roy et al. (2023) conducted a cohort in Thoracolumbar fusion with major complication (n=15,749). Frailty (Risk Analysis Index ≥ 46) vs. Robust patients (Risk Analysis Index 0-20) was evaluated on Failure to rescue (30-day mortality following a major complication) (OR 45.79, 95% CI 14.82-141.50, p=<0.001). Very frail patients (RAI ≥ 46) had a 45.8-fold increased odds of failure to rescue (30-day mortality following a major complication) compared to robust patients after thoracolumbar fusion.
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