Key result
An mFI-5 score of 3+ was an independent predictor of any 30-day complication (OR 1.5; 95% CI 1.01-2.2; p=0.004) compared to a score of 0 in patients over 50 undergoing elective ALIF.
Why the study?
The utility of the 5-factor modified frailty index (mFI-5) for predicting adverse events had not been assessed in patients undergoing anterior lumbar interbody fusion.
Does a higher mFI-5 score predict 30-day postoperative adverse events in adults over 50 undergoing elective ALIF?
Cohort (n=11,711)
Yes
Does a higher mFI-5 score predict 30-day postoperative adverse events in adults over 50 undergoing elective ALIF?
The mFI-5 is a significant independent predictor of 30-day postoperative complications and readmissions following elective ALIF in older adults.
May guide risk stratification for elective ALIF; leaves open prospective validation and intervention trials.
Background: The 5-factor modified frailty index (mFI-5) has been shown to be a concise and effective tool for predicting adverse events following various spine procedures. However, there have been no studies assessing its utility in patients undergoing anterior lumbar interbody fusion (ALIF). Therefore, the aim of this study was to analyze the predictive capabilities of the mFI-5 for 30-day postoperative adverse events following elective ALIF. Methods: The National Surgical Quality Improvement Program (NSQIP) database was queried from 2010 through 2019 to identify patients who underwent elective ALIF using Current Procedural Terminology (CPT) codes in patients over the age of 50. The mFI-5 score was calculated using variables for hypertension, congestive heart failure, comorbid diabetes, chronic obstructive pulmonary disease, and partially or fully dependent functional status which were each assigned 1 point. Univariate analysis and multivariate logistic regression models were utilized to identify the associations between mFI-5 scores, and 30-day rates of overall complications, readmissions, reoperations, and mortality. Results: 11,711 patients were included (mFI-5=0: 4,026 patients, mFI-5=1: 5,392, mFI-5=2: 2,102, mFI-5=3+: 187. Multivariate logistic regression revealed that mFI-5 scores of 1 (OR: 2.2, CI: 1.2-4.2, p=0.02), 2 (OR: 3.6, CI: 1.8-7.3, p<0.001), and 3+ (OR: 7.0, CI: 2.5-19.3, p<0.001) versus a score of 0 were significant predictors of pneumonia. An mFI-5 score of 2 (OR: 1.3; CI: 1.01-1.6, p=0.04), and 3+ (OR: 1.9; CI: 1.1-3.1; p=0.01) were both independent predictors of related readmissions. An mFI score of 3+ was an independent predictor of any complication (OR: 1.5, CI: 1.01-2.2, p=0.004), UTI (OR: 2.4, CI: 1.1-5.2, p=0.02), and unplanned intubation (OR: 4.5, CI: 1.3-16.1, p=0.02). Conclusions: The mFI-5 is an independent predictor for 30-day postoperative complications, readmissions, UTI, pneumonia, and unplanned intubations following elective ALIF surgery in adults over the age of 50.
No takes yet. Share an insight, caveat, or question.
Patel et al. (2022) conducted a cohort in Elective Anterior Lumbar Interbody Fusion (ALIF) (n=11,711). 5-factor modified frailty index (mFI-5) score of 3+ vs. mFI-5 score of 0 was evaluated on Any complication (OR 1.5, 95% CI 1.01-2.2, p=0.004). An mFI-5 score of 3+ was an independent predictor of any 30-day complication (OR 1.5; 95% CI 1.01-2.2; p=0.004) compared to a score of 0 in patients over 50 undergoing elective ALIF.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: