Key result
The 11-item and 5-item modified frailty indices showed a significant positive correlation (r=0.655 and r=0.533, respectively) with the Revised Cardiac Risk Index for predicting 30-day major adverse cardiac events after adult spinal deformity surgery.
Why the study?
Cardiac complications are a major cause of death after major spinal surgery, prompting evaluation of how modified frailty indices correlate with RCRI for predicting MACEs after adult spinal deformity surgery.
Do the modified frailty indices (mFI-5 and mFI-11) correlate with the revised cardiac risk index (RCRI) for predicting 30-day major adverse cardiac events in adults undergoing spinal deformity surgery?
Cohort (n=20)
No
Do the modified frailty indices (mFI-5 and mFI-11) correlate with the revised cardiac risk index (RCRI) for predicting 30-day major adverse cardiac events in adults undergoing spinal deformity surgery?
Effect estimate: r=0.655
p-value: p=0.002
Modified frailty indices (mFI-5 and mFI-11) correlate significantly with the Revised Cardiac Risk Index (RCRI) and may provide additional prognostic value for predicting 30-day MACE after adult spinal deformity surgery.
May complement RCRI for preoperative MACE risk assessment in spinal surgery; leaves open incremental prognostic value pending validation.
Objective: Cardiac complications are one of the most important causes of death after major spinal surgery.This study aimed to evaluate the correlation between the 11-item and 5-item modified frailty index (mFI) and the revised cardiac risk index (RCRI) for predicting major adverse cardiac events (MACEs) after adult spinal deformity (ASD) corrective surgery. Materials and Methods:This retrospective study analyzed the records of 20 adult patients who underwent spine surgery for ASD between 2022-2023.The patients' frailty and comorbidities were assessed using the mFI-5, mFI-11, and the American Society of Anesthesiologists Physical Status Classification System.RCRI was calculated to stratify the risk for predicting MACEs during hospitalization.The primary outcome was the presence of specific cardiac events within 30 days of surgery.Results: The study found that there was a significant positive correlation between RCRI and both mFI-5 and mFI-11 scores in terms of predicting MACEs.Three out of the 20 patients had MACEs postoperatively, and among them, one patient had an RCRI score of 1 but had a higher mFI score, indicating frailty.The other two patients had low RCRI scores but were considered prefrail according to the mFI scores.Conclusion: RCRI, mFI-5, and mFI-11 are correlated in terms of predicting cardiac risk after ASD surgery.Adding frailty scores to traditional risk estimation may provide additional prognostic information.However, this needs further investigation.
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Zor et al. (2023) conducted a cohort in Adult spinal deformity (ASD) (n=20). Modified frailty index (mFI-5 and mFI-11) was evaluated on Major adverse cardiac events (MACE) within 30 days of surgery (r=0.655, p=0.002). The 11-item and 5-item modified frailty indices showed a significant positive correlation (r=0.655 and r=0.533, respectively) with the Revised Cardiac Risk Index for predicting 30-day major adverse cardiac events after adult spinal deformity surgery.
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