Frailty predicts non-home discharge in anterior lumbar interbody fusion patients.

IF 1.3 4区 医学 Q4 CLINICAL NEUROLOGY
Derek B Asserson, Danielle A Alaouieh, Joanna M Roy, Meic H Schmidt, Christian A Bowers
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引用次数: 0

Abstract

Background: Anterior lumbar interbody fusion (ALIF) is a well-established surgical approach in the treatment of degenerative pathology, trauma, infection, and neoplasia of the spine. This study sought to assess the usefulness of frailty as a predictor of non-home discharge (NHD) for patients who undergo the procedure.

Methods: Patient cases were extracted from the American College of Surgeons's National Surgical Quality Improvement Program database from 2012 to 2020. Univariable and receiver operating characteristic curve analyses were used to compare the 5-item Modified Frailty Index (mFI-5) to the Revised Risk Analysis Index (RAI-rev) in relation to NHD.

Results: Simple linear regression demonstrated that increasing frailty was associated with an increased likelihood of NHD among 25,317 patients (mFI-5 odds ratio: 2.13, 3.23, 8.4; RAI-rev odds ratio: 3.22, 9.6, 23.6 [P<0.001 for all]). In each instance, a Cochran-Armitage trend test was significant (P<0.001), indicating a linear association of increasing odds. The RAI-rev resulted in a C-statistic of 0.722, compared to 0.628 for the mFI-5, and was shown to have superior discriminative ability with a DeLong Test (P<0.001).

Conclusions: Frailty, as measured by mFI-5 and RAI-rev, was associated with an increased likelihood of NHD in patients who underwent ALIF. This finding supports recent literature on the promising utility of these indices, especially the RAI-rev, in preoperative decision-making across multiple facets of neurosurgery.

前路腰椎椎间融合术患者体质虚弱预示着不能出院回家。
背景:腰椎前路椎体间融合术(ALIF)是治疗脊柱退行性病变、创伤、感染和肿瘤的一种行之有效的手术方法。本研究旨在评估虚弱程度作为接受该手术的患者非居家出院(NHD)预测指标的实用性:从美国外科学院的国家外科质量改进计划数据库中提取了2012年至2020年的患者病例。使用单变量分析和接收者操作特征曲线分析比较了5项改良虚弱指数(mFI-5)和修订风险分析指数(RAI-rev)与非住家病症的关系:简单线性回归结果表明,在 25,317 名患者中,体弱程度的增加与罹患 NHD 的可能性增加有关(mFI-5 的几率比:2.13, 3.23, 8.4;RAI-rev 的几率比:3.22, 9.6, 23.6[结论:用 mFI-5 和 RAI-rev 测量的虚弱程度与接受 ALIF 的患者发生 NHD 的可能性增加有关。 这一发现支持了最近的文献,这些指数,尤其是 RAI-rev 在神经外科多个方面的术前决策中具有良好的实用性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of neurosurgical sciences
Journal of neurosurgical sciences CLINICAL NEUROLOGY-SURGERY
CiteScore
3.00
自引率
5.30%
发文量
202
审稿时长
>12 weeks
期刊介绍: The Journal of Neurosurgical Sciences publishes scientific papers on neurosurgery and related subjects (electroencephalography, neurophysiology, neurochemistry, neuropathology, stereotaxy, neuroanatomy, neuroradiology, etc.). Manuscripts may be submitted in the form of ditorials, original articles, review articles, special articles, letters to the Editor and guidelines. The journal aims to provide its readers with papers of the highest quality and impact through a process of careful peer review and editorial work.
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