External Validation of the Adult Spinal Deformity (ASD) Frailty Index (ASD-FI) in the Scoli-RISK-1 Patient Database.

dc.contributor.author

Miller, Emily K

dc.contributor.author

Lenke, Lawrence G

dc.contributor.author

Neuman, Brian J

dc.contributor.author

Sciubba, Daniel M

dc.contributor.author

Kebaish, Khaled M

dc.contributor.author

Smith, Justin S

dc.contributor.author

Qiu, Yong

dc.contributor.author

Dahl, Benny T

dc.contributor.author

Pellisé, Ferran

dc.contributor.author

Matsuyama, Yukihiro

dc.contributor.author

Carreon, Leah Y

dc.contributor.author

Fehlings, Michael G

dc.contributor.author

Cheung, Kenneth M

dc.contributor.author

Lewis, Stephen

dc.contributor.author

Dekutoski, Mark B

dc.contributor.author

Schwab, Frank J

dc.contributor.author

Boachie-Adjei, Oheneba

dc.contributor.author

Mehdian, Hossein

dc.contributor.author

Bess, Shay

dc.contributor.author

Shaffrey, Christopher I

dc.contributor.author

Ames, Christopher P

dc.contributor.author

AOSpine Knowledge Forum Deformity, the International Spine Study Group

dc.date.accessioned

2023-06-20T15:50:11Z

dc.date.available

2023-06-20T15:50:11Z

dc.date.issued

2018-10

dc.date.updated

2023-06-20T15:50:10Z

dc.description.abstract

Study design

Analysis of a prospective multicenter database.

Objective

To assess the ability of the recently created Adult Spinal Deformity (ASD) Frailty Index (ASD-FI) to predict odds of major complications and length of hospital stay for patients who had more severe preoperative deformity and underwent more invasive ASD surgery compared with patients in the database used to create the index.

Summary of background data

Accurate preoperative estimates of risk are necessary given the high complication rates currently associated with ASD surgery.

Methods

Patients were enrolled by participating institutions in Europe, Asia, and North America from 2009 to 2011. ASD-FI scores were used to classify 267 patients as not frail (NF) (<0.3), frail (0.3-0. 5), or severely frail (SF) (>0.5). Multivariable logistic regression, adjusted for preoperative and surgical covariates such as operative time and blood loss, was performed to determine the relationship between ASD-FI category and incidence of major complications, overall incidence of complications, and length of hospital stay.

Results

The mean ASD-FI score was 0.3 (range, 0-0.7). We categorized 105 patients as NF, 103 as frail, and 59 as SF. The adjusted odds of developing a major complication were higher for SF patients (odds ratio = 4.4; 95% CI 2.0, 9.9) compared with NF patients. After adjusting for covariates, length of hospital stay for SF patients increased by 19% (95% CI 1.4%, 39%) compared with NF patients. The odds of developing a major complication or having increased length of stay were similar between frail and NF patients.

Conclusion

Greater patient frailty, as measured by the ASD-FI, is associated with a longer hospital stay and greater risk of major complications among patients who have severe preoperative deformity and undergo invasive surgical procedures.

Level of evidence

2.
dc.identifier

00007632-201810150-00014

dc.identifier.issn

0362-2436

dc.identifier.issn

1528-1159

dc.identifier.uri

https://hdl.handle.net/10161/28244

dc.language

eng

dc.publisher

Ovid Technologies (Wolters Kluwer Health)

dc.relation.ispartof

Spine

dc.relation.isversionof

10.1097/brs.0000000000002717

dc.subject

AOSpine Knowledge Forum Deformity, the International Spine Study Group

dc.subject

Humans

dc.subject

Spinal Diseases

dc.subject

Postoperative Complications

dc.subject

Length of Stay

dc.subject

Neurosurgical Procedures

dc.subject

Logistic Models

dc.subject

Prospective Studies

dc.subject

Databases, Factual

dc.subject

Adult

dc.subject

Aged

dc.subject

Middle Aged

dc.subject

Female

dc.subject

Male

dc.subject

Frailty

dc.title

External Validation of the Adult Spinal Deformity (ASD) Frailty Index (ASD-FI) in the Scoli-RISK-1 Patient Database.

dc.type

Journal article

duke.contributor.orcid

Shaffrey, Christopher I|0000-0001-9760-8386

pubs.begin-page

1426

pubs.end-page

1431

pubs.issue

20

pubs.organisational-group

Duke

pubs.organisational-group

School of Medicine

pubs.organisational-group

Clinical Science Departments

pubs.organisational-group

Orthopaedic Surgery

pubs.organisational-group

Neurosurgery

pubs.publication-status

Published

pubs.volume

43

Files

Original bundle

Now showing 1 - 1 of 1
Loading...
Thumbnail Image
Name:
External Validation of the Adult Spinal Deformity (ASD) Frailty Index (ASD-FI) in the Scoli-RISK-1 Patient Database.pdf
Size:
558.42 KB
Format:
Adobe Portable Document Format