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  1. Article ; Online: The 5-item modified frailty index predicts spinal osteotomy outcomes better than age in adult spinal deformity patients: an ACS - NSQIP analysis.

    Tarawneh, Omar H / Vellek, John / Kazim, Syed Faraz / Thommen, Rachel / Roster, Katie / Conlon, Matthew / Alvarez-Crespo, Daniel J / Cole, Kyril L / Varela, Samantha / Dominguez, Jose F / Mckee, Rohini G / Schmidt, Meic H / Bowers, Christian A

    Spine deformity

    2023  Volume 11, Issue 5, Page(s) 1189–1197

    Abstract: Purpose: To evaluate the utility of 5-Item Modified Frailty Index (mFI-5) as compared to chronological age in predicting outcomes of spinal osteotomy in Adult Spinal Deformity (ASD) patients.: Methods: Using Current Procedural and Terminology (CPT) ... ...

    Abstract Purpose: To evaluate the utility of 5-Item Modified Frailty Index (mFI-5) as compared to chronological age in predicting outcomes of spinal osteotomy in Adult Spinal Deformity (ASD) patients.
    Methods: Using Current Procedural and Terminology (CPT) codes, the American College of Surgeons National Surgery Quality Improvement Program (ACS-NSQIP) database was queried for adult patients undergoing spinal osteotomy from 2015 to 2019. Multivariate regression analysis was performed to evaluate the effect of baseline frailty status, measured by mFI-5 score, and chronological age on postoperative outcomes. Receiver-operating characteristic (ROC) curve analysis was performed to analyze the discriminative performance of age versus mFI-5.
    Results: A total of 1,789 spinal osteotomy patients (median age 62 years) were included in the analysis. Among the patients assessed, 38.5% (n = 689) were pre-frail, 14.6% frail (n = 262), and 2.2% (n = 39) severely frail using the mFI-5. Based on the multivariate analysis, increasing frailty tier was associated with worsening outcomes, and higher odds ratios (OR) for poor outcomes were found for increasing frailty tiers as compared to age. Severe frailty was associated with the worst outcomes, e.g., unplanned readmission (OR 9.618, [95% CI 4.054-22.818], p < 0.001) and major complications (OR 5.172, [95% CI 2.271-11.783], p < 0.001). In the ROC curve analysis, mFI-5 score (AUC 0.838) demonstrated superior discriminative performance than age (AUC 0.601) for mortality.
    Conclusions: The mFI5 frailty score was found to be a better predictor than age of worse postoperative outcomes in ASD patients. Incorporating frailty in preoperative risk stratification is recommended in ASD surgery.
    MeSH term(s) Humans ; Adult ; Middle Aged ; Frailty/complications ; Quality Improvement ; Databases, Factual ; Osteotomy/adverse effects ; Postoperative Complications/epidemiology ; Postoperative Complications/etiology
    Language English
    Publishing date 2023-06-08
    Publishing country England
    Document type Journal Article
    ZDB-ID 2717704-X
    ISSN 2212-1358 ; 2212-134X ; 2212-1358
    ISSN (online) 2212-1358 ; 2212-134X
    ISSN 2212-1358
    DOI 10.1007/s43390-023-00712-y
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Preoperative frailty risk in deep brain stimulation patients: Risk analysis index predicts Clavien-Dindo IV complications.

    Owodunni, Oluwafemi P / Roster, Katie / Varela, Samantha / Kazim, Syed F / Okakpu, Uchenna / Tarawneh, Omar H / Thommen, Rachel / Kogan, Michael / Sheehan, Jason / Mckee, Rohini / Deligtisch, Amanda / Schmidt, Meic H / Bowers, Christian A

    Clinical neurology and neurosurgery

    2023  Volume 226, Page(s) 107616

    Abstract: Objective: Deep brain stimulation (DBS) improves patients' quality of life in multiple movement disorders and chronic neurodegenerative diseases. There are no published studies assessing frailty's impact on DBS outcomes. We evaluated frailty's impacts ... ...

    Abstract Objective: Deep brain stimulation (DBS) improves patients' quality of life in multiple movement disorders and chronic neurodegenerative diseases. There are no published studies assessing frailty's impact on DBS outcomes. We evaluated frailty's impacts on DBS outcomes, comparing discriminative thresholds of the risk analysis index (RAI) to modified frailty index-5 (mFI-5) for predicting Clavien-Dindo complications (CDIV).
    Methods: Patients who underwent DBS between 2015 and 2019 in the ACS-NSQIP registry were included. We employed receiver operating characteristic (ROC) curve to examine the discriminative thresholds of RAI and mFI-5 and multivariable analyses for postoperative outcomes. Our primary outcome was CDIV, and secondary outcomes were discharge to higher-level care facility, unplanned reoperation within 30 days, in any hospital, for any procedure related to the index procedure, and extended length of stay.
    Results: A total of 3795 patients were included. In the ROC analysis for CDIV, RAI showed superior discriminative threshold (C-statistic = 0.70, 95% CI 0.61-0.80, <0.001) than mFI-5 (C-statistic = 0.60, 95% CI 0.49-0.70, P = 0.08). On multivariable analyses, frailty stratified by RAI, had independent associations with CDIV, i.e., pre-frail 2-fold increase OR 2.04 (95% CI: 1.94-2.14) p < 0.001, and frail 39% increase OR 1.39 (95% CI: 1.27-1.53), p < 0.001.
    Conclusion: Frailty was an independent risk-factor for CDIV. The RAI had superior discriminative thresholds than mFI-5 in predicting CDIV after DBS. Our ability to identify frail patients prior to DBS presents a novel clinical opportunity for quality improvement strategies to target this specific patient population. RAI may be a useful primary frailty screening modality for potential DBS candidates.
    MeSH term(s) Humans ; Frailty/complications ; Quality of Life ; Deep Brain Stimulation/adverse effects ; Postoperative Complications/epidemiology ; Risk Assessment/methods ; Risk Factors ; Retrospective Studies
    Language English
    Publishing date 2023-02-08
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 193107-6
    ISSN 1872-6968 ; 0303-8467
    ISSN (online) 1872-6968
    ISSN 0303-8467
    DOI 10.1016/j.clineuro.2023.107616
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    In stock of ZB MED Cologne/Königswinter

    Ui I Zs.53: Show issues Location:
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    bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular
    ab Jg. 2022: Lesesaal (EG)

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  3. Article ; Online: Worse Pituitary Adenoma Surgical Outcomes Predicted by Increasing Frailty, Not Age.

    Thommen, Rachel / Kazim, Syed Faraz / Cole, Kyril L / Olson, Garth T / Shama, Liat / Lovato, Christina M / Gonzales, Kristen M / Dicpinigaitis, Alis J / Couldwell, William T / Mckee, Rohini G / Cole, Chad D / Schmidt, Meic H / Bowers, Christian A

    World neurosurgery

    2022  Volume 161, Page(s) e347–e354

    Abstract: Purpose: Increasing patient age has been associated with worse outcomes after pituitary adenoma resection in previous studies, but the prognostic value of frailty compared with advancing age on pituitary adenoma resection outcomes has not been clearly ... ...

    Abstract Purpose: Increasing patient age has been associated with worse outcomes after pituitary adenoma resection in previous studies, but the prognostic value of frailty compared with advancing age on pituitary adenoma resection outcomes has not been clearly evaluated.
    Methods: The National Surgical Quality Improvement Program from 2015 to 2019 was queried for data for patients aged >18 years who underwent pituitary adenoma resection (n = 1454 identified patients). Univariate and multivariate analyses of age and frailty (5-factor modified frailty index [mFI-5]) were performed on 30-day mortality, major complications, extended length of stay (eLOS), discharge destination, and readmission and reoperation. The receiver operating characteristic curve analysis was performed to compare effect of age and mFI-5.
    Results: On univariate analysis, increasing frailty was significantly associated with greater risk of unplanned readmission (frail: odds ratio [OR], 1.9; 95% confidence interval [CI], 1.2-3.2; severely frail: OR, 6.9; 95% CI, 2.4-19.8) and a major complication (frail: OR, 3.6; 95% CI, 2.1-6.1). Severe frailty was also associated with nonhome discharge (OR, 10.6; 95% CI, 3.2-35.8) and eLOS (OR, 4.5; 95% CI, 1.5-13.4). Increasing age was not associated with any of these outcome measures. Multivariate analysis also demonstrated similar trends. In receiver operating characteristic curve analysis, the mFI-5 score showed higher discrimination for major complications compared with age (area under the curve: 0.624 vs. 0.503; P < 0.001).
    Conclusion: Increasing frailty, and not advancing age, was an independent predictor for major complications, unplanned readmissions, eLOS, and nonhome discharge after pituitary adenoma resection, suggesting frailty to be superior to age in preoperative risk stratification in this patient population.
    MeSH term(s) Adenoma/surgery ; Frailty ; Humans ; Patient Readmission ; Pituitary Neoplasms/surgery ; Treatment Outcome
    Language English
    Publishing date 2022-02-05
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2534351-8
    ISSN 1878-8769 ; 1878-8750
    ISSN (online) 1878-8769
    ISSN 1878-8750
    DOI 10.1016/j.wneu.2022.02.002
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    In stock of ZB MED Cologne/Königswinter

    Zs.A 1159: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

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  4. Article: Frailty Status Is a More Robust Predictor Than Age of Spinal Tumor Surgery Outcomes: A NSQIP Analysis of 4,662 Patients.

    Kazim, Syed Faraz / Dicpinigaitis, Alis J / Bowers, Christian A / Shah, Smit / Couldwell, William T / Thommen, Rachel / Alvarez-Crespo, Daniel J / Conlon, Matthew / Tarawneh, Omar H / Vellek, John / Cole, Kyrill L / Dominguez, Jose F / Mckee, Rohini N / Ricks, Christian B / Shin, Peter C / Cole, Chad D / Schmidt, Meic H

    Neurospine

    2022  Volume 19, Issue 1, Page(s) 53–62

    Abstract: Objective: The present study aimed to evaluate the effect of baseline frailty status (as measured by modified frailty index-5 [mFI-5]) versus age on postoperative outcomes of patients undergoing surgery for spinal tumors using data from a large national ...

    Abstract Objective: The present study aimed to evaluate the effect of baseline frailty status (as measured by modified frailty index-5 [mFI-5]) versus age on postoperative outcomes of patients undergoing surgery for spinal tumors using data from a large national registry.
    Methods: The National Surgical Quality Improvement Program database was used to collect spinal tumor resection patients' data from 2015 to 2019 (n = 4,662). Univariate and multivariate analyses for age and mFI-5 were performed for the following outcomes: 30-day mortality, major complications, unplanned reoperation, unplanned readmission, hospital length of stay (LOS), and discharge to a nonhome destination. Receiver operating characteristic (ROC) curve analysis was used to evaluate the discriminative performance of age versus mFI-5.
    Results: Both univariate and multivariate analyses demonstrated that mFI-5 was a more robust predictor of worse postoperative outcomes as compared to age. Furthermore, based on categorical analysis of frailty tiers, increasing frailty was significantly associated with increased risk of adverse outcomes. 'Severely frail' patients were found to have the highest risk, with odds ratio 16.4 (95% confidence interval [CI],11.21-35.44) for 30-day mortality, 3.02 (95% CI, 1.97-4.56) for major complications, and 2.94 (95% CI, 2.32-4.21) for LOS. In ROC curve analysis, mFI-5 score (area under the curve [AUC] = 0.743) achieved superior discrimination compared to age (AUC = 0.594) for mortality.
    Conclusion: Increasing frailty, as measured by mFI-5, is a more robust predictor as compared to age, for poor postoperative outcomes in spinal tumor surgery patients. The mFI-5 may be clinically used for preoperative risk stratification of spinal tumor patients.
    Language English
    Publishing date 2022-02-02
    Publishing country Korea (South)
    Document type Journal Article
    ZDB-ID 3031654-6
    ISSN 2586-6591 ; 2586-6583
    ISSN (online) 2586-6591
    ISSN 2586-6583
    DOI 10.14245/ns.2142770.385
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  5. Article ; Conference proceedings: Preoperative Frailty Measured by Clinical Risk Analysis Index (RAI-C) and Adverse Events after Endoscopic Endonasal Surgery for Pituitary Adenoma: A Single-Center Prospective Case Series

    Marquez, Joshua / Spangler, Benjamin Q. / Rumalla, Kavelin / Kazim, Syed Faraz / Courville, Evan / Patel, Sagar A. / Lundquist, Dominic K. / Muka, Theodore N. / Varela, Samantha / Olson, Garth T. / Shama, Liat N. / Mckee, Rohini G. / Schmidt, Meic H. / Bowers, Christian A.

    Journal of Neurological Surgery Part B: Skull Base

    2023  Volume 84, Issue S 01

    Event/congress 32nd Annual Meeting North American Skull Base Society, JW Marriott Tampa Water Street, Tampa, Florida, United States, 2023-02-17
    Language English
    Publishing date 2023-02-01
    Publisher Georg Thieme Verlag KG
    Publishing place Stuttgart ; New York
    Document type Article ; Conference proceedings
    ZDB-ID 2654269-9
    ISSN 2193-634X ; 2193-6331
    ISSN (online) 2193-634X
    ISSN 2193-6331
    DOI 10.1055/s-0043-1762299
    Database Thieme publisher's database

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 3425: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)

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