Key result
Baseline frailty status, most commonly measured by the 11-factor modified frailty index (37.2%), is widely utilized to predict neurosurgical outcomes such as post-operative complications (53.2%).
Why the study?
Does baseline frailty status predict postoperative outcomes in neurosurgery?
Systematic Review (n=244)
Does baseline frailty status predict postoperative outcomes in neurosurgery?
Frailty literature in neurosurgery has grown exponentially, with the mFI-11 being the most utilized index to predict postoperative outcomes, particularly complications in spine surgery.
Supports preoperative frailty screening for risk stratification; reinforces mFI-11 as dominant predictor of neurosurgical complications.
INTRODUCTION: Baseline frailty status has been utilized to predict a wide range of outcomes and guide preoperative decision making in neurosurgery. This systematic review aims to analyze existing literature on the utilization of frailty as a predictor of neurosurgical outcomes.EVIDENCE ACQUISITION: We conducted a systematic review following PRISMA guidelines. Studies that utilized baseline frailty status to predict outcomes after a neurosurgical intervention were included in this systematic review. Studies that utilized sarcopenia as the sole measure of frailty were excluded. PubMed, EMBASE, and Cochrane library was searched from inception to March 1st, 2023, to identify relevant articles.EVIDENCE SYNTHESIS: Overall, 244 studies met the inclusion criteria. The 11-factor modified frailty index (mFI-11) was the most utilized frailty measure (N.=91, 37.2%) followed by the five-factor modified Frailty Index (mFI-5) (N.=80, 32.7%). Spine surgery was the most common subspecialty (N.=131, 53.7%), followed by intracranial tumor resection (N.=57, 23.3%), and post-operative complications were the most reported outcome (N.=130, 53.2%) in neurosurgical frailty studies. The USA and the Bowers author group published the greatest number of articles within the study period (N.=176, 72.1% and N.=37, 15.2%, respectively).CONCLUSIONS: Frailty literature has grown exponentially over the years and has been incorporated into neurosurgical decision making. Although a wide range of frailty indices exist, their utility may vary according to their ability to be incorporated in the outpatient clinical setting.
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Roy et al. (2023) conducted a systematic review in Neurosurgery (n=244). Baseline frailty status was evaluated on Post-operative complications. Baseline frailty status, most commonly measured by the 11-factor modified frailty index (37.2%), is widely utilized to predict neurosurgical outcomes such as post-operative complications (53.2%).
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