Christoph Schwartz, Moritz F Ueberschaer, Ilari Rautalin, Jürgen Grauvogel, Marco Bissolo, Waseem Masalha, Christine Steiert, Oliver Schnell, Jürgen Beck, Florian Ebel, David Bervini, Andreas Raabe, Thomas Eibl, Hans-Herbert Steiner, Karl-Michael Schebesch, Nathan A Shlobin, Khizar R Nandoliya, Mark W Youngblood, James P Chandler, Stephen T Magill, Alexander Romagna, Jens Lehmberg, Manuel Fuetsch, Julian Spears, Arwin Rezai, Barbara Ladisich, Matthias Demetz, Christoph J Griessenauer, Mika Niemelä, Miikka Korja
{"title":"Frailty indices predict mortality, complications and functional improvements in supratentorial meningioma patients over 80 years of age.","authors":"Christoph Schwartz, Moritz F Ueberschaer, Ilari Rautalin, Jürgen Grauvogel, Marco Bissolo, Waseem Masalha, Christine Steiert, Oliver Schnell, Jürgen Beck, Florian Ebel, David Bervini, Andreas Raabe, Thomas Eibl, Hans-Herbert Steiner, Karl-Michael Schebesch, Nathan A Shlobin, Khizar R Nandoliya, Mark W Youngblood, James P Chandler, Stephen T Magill, Alexander Romagna, Jens Lehmberg, Manuel Fuetsch, Julian Spears, Arwin Rezai, Barbara Ladisich, Matthias Demetz, Christoph J Griessenauer, Mika Niemelä, Miikka Korja","doi":"10.1007/s11060-024-04780-6","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>To assess whether the Modified 5 (mFI-5) and 11 (mFI-11) Factor Frailty Indices associate with postoperative mortality, complications, and functional benefit in supratentorial meningioma patients aged over 80 years.</p><p><strong>Methods: </strong>Baseline characteristics were collected from eight centers. Based on the patients' preoperative status and comorbidities, frailty was assessed by the mFI-5 and mFI-11. The collected scores were categorized as \"robust (mFI=0)\", \"pre-frail (mFI=1)\", \"frail (mFI=2)\", and \"significantly frail (mFI≥3)\". Outcome was assessed by the Karnofsky Performance Scale (KPS); functional benefit was defined as improved KPS score. Additionally, we evaluated the patients' functional independence (KPS≥70) after surgery.</p><p><strong>Results: </strong>The study population consisted of 262 patients (median age 83 years) with a median preoperative KPS of 70 (range 20 to 100). The 90-day and 1-year mortality were 9.0% and 13.2%; we recorded surgery-associated complications in 111 (42.4%) patients. At last follow-up within the postoperative first year, 101 (38.5%) patients showed an improved KPS, and 183 (69.8%) either gained or maintained functional independence. \"Severely frail\" patients were at an increased risk of death at 90 days (OR 16.3 (CI95% 1.7-158.7)) and one year (OR 11.7 (CI95% 1.9-71.7)); nine (42.9%) of severely frail patients died within the first year after surgery. The \"severely frail\" cohort had increased odds of suffering from surgery-associated complications (OR 3.9 (CI 95%) 1.3-11.3)), but also had a high chance for postoperative functional improvements by KPS≥20 (OR 6.6 (CI95% 1.2-36.2)).</p><p><strong>Conclusion: </strong>The mFI-5 and mFI-11 associate with postoperative mortality, complications, and functional benefit. Even though \"severely frail\" patients had the highest risk morbidity and mortality, they had the highest chance for functional improvement.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":null,"pages":null},"PeriodicalIF":3.2000,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Neuro-Oncology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s11060-024-04780-6","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Purpose: To assess whether the Modified 5 (mFI-5) and 11 (mFI-11) Factor Frailty Indices associate with postoperative mortality, complications, and functional benefit in supratentorial meningioma patients aged over 80 years.
Methods: Baseline characteristics were collected from eight centers. Based on the patients' preoperative status and comorbidities, frailty was assessed by the mFI-5 and mFI-11. The collected scores were categorized as "robust (mFI=0)", "pre-frail (mFI=1)", "frail (mFI=2)", and "significantly frail (mFI≥3)". Outcome was assessed by the Karnofsky Performance Scale (KPS); functional benefit was defined as improved KPS score. Additionally, we evaluated the patients' functional independence (KPS≥70) after surgery.
Results: The study population consisted of 262 patients (median age 83 years) with a median preoperative KPS of 70 (range 20 to 100). The 90-day and 1-year mortality were 9.0% and 13.2%; we recorded surgery-associated complications in 111 (42.4%) patients. At last follow-up within the postoperative first year, 101 (38.5%) patients showed an improved KPS, and 183 (69.8%) either gained or maintained functional independence. "Severely frail" patients were at an increased risk of death at 90 days (OR 16.3 (CI95% 1.7-158.7)) and one year (OR 11.7 (CI95% 1.9-71.7)); nine (42.9%) of severely frail patients died within the first year after surgery. The "severely frail" cohort had increased odds of suffering from surgery-associated complications (OR 3.9 (CI 95%) 1.3-11.3)), but also had a high chance for postoperative functional improvements by KPS≥20 (OR 6.6 (CI95% 1.2-36.2)).
Conclusion: The mFI-5 and mFI-11 associate with postoperative mortality, complications, and functional benefit. Even though "severely frail" patients had the highest risk morbidity and mortality, they had the highest chance for functional improvement.
期刊介绍:
The Journal of Neuro-Oncology is a multi-disciplinary journal encompassing basic, applied, and clinical investigations in all research areas as they relate to cancer and the central nervous system. It provides a single forum for communication among neurologists, neurosurgeons, radiotherapists, medical oncologists, neuropathologists, neurodiagnosticians, and laboratory-based oncologists conducting relevant research. The Journal of Neuro-Oncology does not seek to isolate the field, but rather to focus the efforts of many disciplines in one publication through a format which pulls together these diverse interests. More than any other field of oncology, cancer of the central nervous system requires multi-disciplinary approaches. To alleviate having to scan dozens of journals of cell biology, pathology, laboratory and clinical endeavours, JNO is a periodical in which current, high-quality, relevant research in all aspects of neuro-oncology may be found.