Assessment of the impact of frailty on adverse surgical outcomes in patients undergoing surgery for intracranial tumors using modified frailty index: A systematic review and meta-analysis

Aghajanian, Sepehr; Shafiee, Arman; Ahmadi, Atefeh; Elsamadicy, Aladine A.

doi:10.1016/j.jocn.2023.06.013

Cited by 5 publications

(2 citation statements)

References 56 publications

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“…The study highlights that frailty indices are more predictive than age alone, advocating for their integration into preoperative evaluations to re ne risk assessments and tailor treatment strategies. 25,26 Nair et al developed predictive models to evaluate the impact of frailty on postoperative outcomes in glioblastoma (GBM) patients, emphasizing the Modi ed Frailty Index (MFI-5) and Karnofsky Performance Status (KPS) as pivotal preoperative indicators. It highlights that increased frailty scores and lower KPS levels are strongly associated with extended hospital length of stay (LOS), nonroutine discharge, and elevated hospital charges, underscoring the profound in uence of preoperative physical health status on post-surgical recovery and costs.…”

Section: Discussionmentioning

confidence: 99%

Evaluating the Predictive Value of the Modified Frailty Index (mFI-5) on Postoperative Outcomes in Patients with High-Grade Gliomas

Zaki,

Herr,

Doori

et al. 2024

Preprint

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Purpose: High-grade gliomas (HGGs) are aggressive brain tumors associated with significant morbidity. This study aims to assess the utility of the 5-factor Modified Frailty Index (mFI-5) in predicting postoperative outcomes and overall survival in patients undergoing surgical resection for HGGs.Methods: We conducted a retrospective analysis of 196 patients treated surgically for GBM at our institution from January 2016 to January 2023. Patients were stratified into three groups based on their preoperative mFI-5 scores: prefrail (< 2), frail (= 2), and severely frail (> 2). Primary outcomes included 30-day, 90-day, and 1-year survival and progression-free survival. Secondary outcomes focused on hospital length of stay (LOS), 30-day readmission rates, and discharge status. Univariate and multivariate analyses evaluated the impact of frailty on these outcomes.Results: Frailty was significantly associated with adverse outcomes. The median progression free survival was 9.2 months in the prefrail, 6.9 months in the frail and 3.5 months in severely frail patients (p = 0.01). Furthermore, the 90-day OS was 89%, 91% and 75% for the prefrail, frail and severely frail group respectively (p = 0.03). However, there was no statistically significant difference in 12-month OS (64%, 70%, 58%; p = 0.72). The median survival for the cohort was 17.9 months in the prefrail, 15.4 months in the frail and 15.3 in the severely frail (p = 0.02). Severely frail patients demonstrated lower rates of symptomatic resolution (66%,53%, 33% respectively; p = 0.005), increased non-home discharge rates (24%, 55.9%, 75%, respectively; P < 0.001), and mRS > 2 upon discharge (5%, 26%, and 66% respectively; P < 0.001).Conclusion: The mFI-5 is a valuable tool for preoperative risk stratification in patients with GBM, predicting short-term survival and postoperative outcomes. Integrating frailty assessments into preoperative evaluations can aid in tailoring surgical and adjuvant therapies, potentially improving patient outcomes and optimizing resource allocation. This study supports the adoption of frailty assessments in neuro-oncological practice to enhance personalized care strategies for patients with HGGs.

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Section: Discussionmentioning

confidence: 99%

Evaluating the Predictive Value of the Modified Frailty Index (mFI-5) on Postoperative Outcomes in Patients with High-Grade Gliomas

Zaki,

Herr,

Doori

et al. 2024

Preprint

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“… 6 This is further highlighted by the variability in its definition and assessment in the existent literature. 7 , 8 Nevertheless, to minimize postoperative complications, the formulation of pragmatic and efficient assessment methodologies is of paramount importance.…”

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confidence: 99%

Impact of maximum phonation time on postoperative dysphagia and prognosis after cardiac surgery

Ogawa,

Satomi-Kobayashi,

Hamaguchi

et al. 2024

JTCVS Open

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Efficacy and utility of antifibrinolytics in pediatric spine surgery: a systematic review and network meta-analysis

Aghajanian,

Mohammadifard,

Kohandel Gargari

et al. 2024

Neurosurg Rev

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Assessment of the impact of frailty on adverse surgical outcomes in patients undergoing surgery for intracranial tumors using modified frailty index: A systematic review and meta-analysis

Cited by 5 publications

References 56 publications

Evaluating the Predictive Value of the Modified Frailty Index (mFI-5) on Postoperative Outcomes in Patients with High-Grade Gliomas

Evaluating the Predictive Value of the Modified Frailty Index (mFI-5) on Postoperative Outcomes in Patients with High-Grade Gliomas

Impact of maximum phonation time on postoperative dysphagia and prognosis after cardiac surgery

Efficacy and utility of antifibrinolytics in pediatric spine surgery: a systematic review and network meta-analysis

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