Jang Hyun-Jun, Chin Dong-Kyu, Park Jeong-Yoon, Kuh Sung-Uk, Kim Keun-Su, Cho Yong-Eun, Kim Kyung-Hyun
Department of Neurosurgery, Spine and Spinal Cord Institute, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Neurospine. 2021 Jun;18(2):303-310. doi: 10.14245/ns.2040688.344. Epub 2021 Jan 23.
Many studies have reported positive surgical outcomes and decreased mortality after spine surgery in the elderly population, including patients between 85 and 90 years of age. Here, in addition to patient age, we investigated the influence of frailty on short and long-term mortality in octogenarians after lumbar surgery.
We performed a retrospective analysis of 162 patients over 80 years of age who underwent posterior lumbar fusion or decompressive laminectomy between January 2011 and September 2016. We examined patient survival and modified frailty index (mFI) from medical records.
By October 2019, 29 of 162 patients had expired (follow-up period: 1-105 months). Three-month mortality was 1.9%, and 1-year mortality was 4.9%. Frailty did not affect long-term survival at 1 year but was associated with 3-month mortality (p = 0.024).
There was no relationship in long-term survival according to frailty in patients 80 years of age or older, but a difference was identified in short-term mortality. When making a surgical decision for lumbar spine surgery in frail patients over 80 years of age, surgeons should pay attention to the short-term prognosis.
许多研究报告了老年人群脊柱手术后积极的手术结果及死亡率降低，包括85至90岁的患者。在此，除了患者年龄外，我们还研究了衰弱对八十多岁老人腰椎手术后短期和长期死亡率的影响。
我们对2011年1月至2016年9月期间接受后路腰椎融合术或减压性椎板切除术的162名80岁以上患者进行了回顾性分析。我们从病历中检查了患者的生存情况和改良衰弱指数（mFI）。
截至2019年10月，162名患者中有29名死亡（随访期：1至105个月）。3个月死亡率为1.9%，1年死亡率为4.9%。衰弱不影响1年的长期生存率，但与3个月死亡率相关（p = 0.024）。
80岁及以上患者的长期生存与衰弱无关，但在短期死亡率方面存在差异。在为80岁以上衰弱患者进行腰椎手术决策时，外科医生应注意短期预后。
