Elsamadicy Aladine A, Koo Andrew B, Reeves Benjamin C, Pennington Zach, Sarkozy Margot, Hersh Andrew, Havlik John, Sherman Josiah J Z, Goodwin C Rory, Kolb Luis, Laurans Maxwell, Larry Lo Sheng-Fu, Shin John H, Sciubba Daniel M
Department of Neurosurgery, Yale University School of Medicine, New Haven, CT, USA.
Department of Neurosurgery, Mayo Clinic, Rochester, MN, USA.
Global Spine J. 2023 Sep;13(7):2074-2084. doi: 10.1177/21925682211069937. Epub 2022 Jan 11.
The Hospital Frailty Risk Score (HFRS) is a metric that measures frailty among patients in large national datasets using ICD-10 codes. While other metrics have been utilized to demonstrate the association between frailty and poor outcomes in spine oncology, none have examined the HFRS. The aim of this study was to investigate the impact of frailty using the HFRS on complications, length of stay, cost of admission, and discharge disposition in patients undergoing surgery for primary tumors of the spinal cord and meninges.
A retrospective cohort study was performed using the Nationwide Inpatient Sample database from 2016 to 2018. Adult patients undergoing surgery for primary tumors of the spinal cord and meninges were identified using ICD-10-CM codes. Patients were categorized into 2 cohorts based on HFRS score: Non-Frail (HFRS<5) and Frail (HFRS≥5). Patient characteristics, treatment, perioperative complications, LOS, discharge disposition, and cost of admission were assessed.
Of the 5955 patients identified, 1260 (21.2%) were Frail. On average, the Frail cohort was nearly 8 years older () and experienced more postoperative complications (). The Frail cohort experienced longer LOS (), a higher rate of non-routine discharge (), and a greater mean cost of admission (). Frailty was found to be an independent predictor of extended LOS () and non-routine discharge ().
Our study is the first to use the HFRS to assess the impact of frailty on patients with primary spinal tumors. We found that frailty was associated with prolonged LOS, non-routine discharge, and increased hospital costs.
医院虚弱风险评分（HFRS）是一种利用国际疾病分类第十版（ICD - 10）编码在大型国家数据集中衡量患者虚弱程度的指标。虽然已使用其他指标来证明虚弱与脊柱肿瘤不良预后之间的关联，但尚无研究考察过HFRS。本研究的目的是调查使用HFRS评估的虚弱对脊髓和脑膜原发性肿瘤手术患者的并发症、住院时间、住院费用及出院处置的影响。
利用2016年至2018年全国住院患者样本数据库进行一项回顾性队列研究。使用ICD - 10 - CM编码识别接受脊髓和脑膜原发性肿瘤手术的成年患者。根据HFRS评分将患者分为两组：非虚弱组（HFRS<5）和虚弱组（HFRS≥5）。评估患者特征、治疗情况、围手术期并发症、住院时间、出院处置及住院费用。
在识别出的5955例患者中，1260例（21.2%）为虚弱组。平均而言，虚弱组患者年龄大近8岁，术后并发症更多。虚弱组住院时间更长，非常规出院率更高，平均住院费用更高。发现虚弱是延长住院时间和非常规出院的独立预测因素。
我们的研究首次使用HFRS评估虚弱对原发性脊柱肿瘤患者的影响。我们发现虚弱与住院时间延长、非常规出院及住院费用增加有关。
