Patel Neil, Coban Daniel, Changoor Stuart, Sinha Kumar, Hwang Ki Soo, Emami Arash
Department of Orthopaedic Surgery, St. Joseph's University Medical Center, Paterson, NJ, USA.
Global Spine J. 2025 Mar;15(2):526-533. doi: 10.1177/21925682231196828. Epub 2023 Aug 19.
Retrospective Cohort Study.
To determine the predictive capability between the 5-factor modified frailty index (mFI-5) scores and adverse clinical and radiographic outcomes following single-level transforaminal lumbar interbody fusion (TLIF).
All patients over the age of 50 undergoing single-level open or minimally invasive TLIF from 2012 to 2021 with a minimum follow-up of 1 year were identified. Deformity, trauma, emergency, and tumor cases were excluded as were patients undergoing revision surgeries. An mFI-5 score was computed for each patient using a set of five factors which included hypertension requiring medication, chronic obstructive pulmonary disease, diabetes mellitus, congestive heart failure, and partially or fully dependent functional status. Univariate and multivariate logistic regression analysis were performed to evaluate the impact of mFI-5 scores on readmissions, reoperations, and postoperative complications.
156 patients were included and grouped according to their level of frailty: no-frailty (mFI = 0, n = 67), mild frailty (mFI = 1, n = 59), and severe frailty (mFI = 2+, n = 30). Multivariate analysis found high levels of frailty (mFI = 2+) to be independent predictors of reoperation (OR: 16.9, CI: 2.7 - 106.9, = .003) and related readmissions (OR = 16.5, CI: 2.6 - 102.7, = .003) as compared to the no-frailty group. An mFI-5 score of 2+ was also predictive of any complication (OR = 4.5, CI: 1.4 - 14.3, = .01) and adjacent segment disease (ASD) (OR = 12.5, CI: 1.2 - 134.0, = .037).
High levels of frailty were predictive of related readmissions, reoperations, any complications, and ASD in older adult patients undergoing single-level TLIF.
回顾性队列研究。
确定5因素改良衰弱指数（mFI-5）评分与单节段经椎间孔腰椎椎间融合术（TLIF）后不良临床和影像学结果之间的预测能力。
确定2012年至2021年间所有年龄超过50岁且接受单节段开放式或微创TLIF手术且随访至少1年的患者。排除畸形、创伤、急诊和肿瘤病例以及接受翻修手术的患者。使用包括需要药物治疗的高血压、慢性阻塞性肺疾病、糖尿病、充血性心力衰竭以及部分或完全依赖功能状态在内的一组五个因素为每位患者计算mFI-5评分。进行单因素和多因素逻辑回归分析，以评估mFI-5评分对再次入院、再次手术和术后并发症的影响。
纳入156例患者，并根据其衰弱程度进行分组：无衰弱（mFI = 0，n = 67）、轻度衰弱（mFI = 1，n = 59）和重度衰弱（mFI = 2+，n = 30）。多因素分析发现，与无衰弱组相比，高衰弱水平（mFI = 2+）是再次手术（OR：16.9，CI：2.7 - 106.9，P =.003）和相关再次入院（OR = 16.5，CI：2.6 - 102.7，P =.003）的独立预测因素。mFI-5评分为2+也可预测任何并发症（OR = 4.5，CI：1.4 - 14.3，P =.01）和相邻节段疾病（ASD）（OR = 12.5，CI：1.2 - 134.0，P =.037）。
高衰弱水平可预测接受单节段TLIF手术的老年患者的相关再次入院、再次手术、任何并发症和ASD。
