1School of Medicine, New York Medical College, Valhalla, New York.
3Department of Neurosurgery, University of New Mexico, Albuquerque, New Mexico; and.
Neurosurg Focus. 2020 Oct;49(4):E16. doi: 10.3171/2020.7.FOCUS20324.
Frailty has been recognized as a predictor of adverse surgical outcomes across multiple surgical disciplines, but until now the relationship between frailty and intracranial meningioma surgery has not been studied. The goal of the present study was to determine the relationship between increasing frailty (determined using the modified Frailty Index [mFI]) and intracranial meningioma resection outcomes (including hospital length of stay [LOS], discharge location, and reoperation and readmission rates).
This is a single-center retrospective cohort study of patients who underwent intracranial meningioma resection between August 2012 and May 2018. Seventy-six patients met the inclusion criteria.
Frailty was associated with increased hospital LOS (p = 0.0218), increased reoperation rate (p = 0.029), and discharge to a higher level of care: an inpatient rehabilitation facility or a skilled nursing facility (p = 0.0002). After multivariable analysis, frailty was determined to be an independent risk factor for increased LOS, worse discharge disposition, and subsequent readmission.
Frailty is an independent risk factor for worse outcomes following intracranial meningioma resection, including increased LOS, reoperations, and worse discharge disposition. Frailty may help stratify preoperative surgical risk, and thus may provide important clinical information to help neurosurgeons and elderly patients weigh the risks and benefits of resection.
虚弱已被认为是多种外科学科不良手术结果的预测因素，但迄今为止，虚弱与颅内脑膜瘤手术之间的关系尚未得到研究。本研究的目的是确定虚弱程度的增加（通过使用改良虚弱指数[mFI]确定）与颅内脑膜瘤切除术结果（包括住院时间[LOS]、出院地点以及再次手术和再入院率）之间的关系。
这是一项单中心回顾性队列研究，纳入 2012 年 8 月至 2018 年 5 月期间接受颅内脑膜瘤切除术的患者。76 名患者符合纳入标准。
虚弱与住院时间延长（p=0.0218）、再次手术率增加（p=0.029）以及出院至更高水平的护理（住院康复机构或熟练护理机构）相关（p=0.0002）。多变量分析后，虚弱被确定为住院时间延长、出院安置较差和随后再入院的独立危险因素。
虚弱是颅内脑膜瘤切除术后结局恶化的独立危险因素，包括住院时间延长、再次手术和出院安置较差。虚弱可能有助于分层术前手术风险，从而为神经外科医生和老年患者权衡切除术的风险和益处提供重要的临床信息。
