Is frailty responsive to surgical correction of adult spinal deformity? An investigation of sagittal re-alignment and frailty component drivers of postoperative frailty status.
dc.contributor.author | Passias, Peter G | |
dc.contributor.author | Segreto, Frank A | |
dc.contributor.author | Moattari, Kevin A | |
dc.contributor.author | Lafage, Renaud | |
dc.contributor.author | Smith, Justin S | |
dc.contributor.author | Line, Breton G | |
dc.contributor.author | Eastlack, Robert K | |
dc.contributor.author | Burton, Douglas C | |
dc.contributor.author | Hart, Robert A | |
dc.contributor.author | Bess, Shay | |
dc.contributor.author | Shaffrey, Christopher I | |
dc.contributor.author | Ames, Christopher P | |
dc.contributor.author | Lafage, Virginie | |
dc.contributor.author | International Spine Study Group | |
dc.date.accessioned | 2023-06-15T17:25:40Z | |
dc.date.available | 2023-06-15T17:25:40Z | |
dc.date.issued | 2022-07 | |
dc.date.updated | 2023-06-15T17:25:39Z | |
dc.description.abstract | PurposeFrailty has been associated with adverse postoperative outcomes. Recently, a novel frailty index for preoperative risk stratification in patients with adult spinal deformity was developed. Components of the ASD-FI utilize patient comorbidity, clinical symptoms, and patient-reported-outcome-measures (PROMS). Our purpose was to investigate components of the Adult Spinal Deformity Frailty Index (ASD-FI) responsive to surgery and drivers of overall frailty.MethodsOperative ASD patients ≥ 18 years, undergoing multilevel fusions, with complete baseline, 6 W, 1Y and 2Y ASD-FI scores. Descriptive analysis assessed demographics, radiographic parameters, and surgical details. Pearson bivariate correlations, independent and paired t tests assessed postoperative changes to ASD-FI components, total score, and radiographic parameters. Linear regression models determined the effect of successful surgery (achieving lowest level SRS-Schwab classification modifiers) on change in ASD-FI total scores.Results409 6-week, 696 1-year, and 253 2-year operative ASD patients were included. 6-week and 1-year baseline frailty scores were 0.34, 2 years was 0.38. Following surgery, 6-week frailty was 0.36 (p = 0.033), 1 year was 0.25 (p < 0.001), and 2 years was 0.28 (p < 0.001). Of the ASD-FI variables, 17/40 improved at 6 weeks, 21/40 at 1 year, and 18/40 at 2 years. Successful surgery significantly predicted decreases in 1-year frailty scores (R = 0.27, p < 0.001), SRS-Schwab SVA modifier was the greatest predictor (Adjusted Beta: - 0.29, p < 0.001).ConclusionsImprovement in sagittal realignment and functional status correlated with improved postoperative frailty. Additional research and deformity sub-group analyses are needed to describe associations between specific functional activities that correlated with frailty improvement as well as evaluation of modifiable and non-modifiable indices.Level of evidence: 3 | |
dc.identifier | 10.1007/s43390-022-00476-x | |
dc.identifier.issn | 2212-134X | |
dc.identifier.issn | 2212-1358 | |
dc.identifier.uri | ||
dc.language | eng | |
dc.publisher | Springer Science and Business Media LLC | |
dc.relation.ispartof | Spine deformity | |
dc.relation.isversionof | 10.1007/s43390-022-00476-x | |
dc.subject | International Spine Study Group | |
dc.subject | Humans | |
dc.subject | Treatment Outcome | |
dc.subject | Retrospective Studies | |
dc.subject | Follow-Up Studies | |
dc.subject | Quality of Life | |
dc.subject | Adult | |
dc.subject | Frailty | |
dc.title | Is frailty responsive to surgical correction of adult spinal deformity? An investigation of sagittal re-alignment and frailty component drivers of postoperative frailty status. | |
dc.type | Journal article | |
duke.contributor.orcid | Shaffrey, Christopher I|0000-0001-9760-8386 | |
pubs.begin-page | 901 | |
pubs.end-page | 911 | |
pubs.issue | 4 | |
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 | 10 |
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