Frailty is associated with morbidity in adults undergoing elective anterior lumbar interbody fusion (ALIF) surgery

Spinal Surgery in Patients Aged 80 Years and Older: Risk Stratification Using the Modified Frailty Index

“…The mFI has been previously associated with postoperative complications and mortality in a mixed spinal surgery cohort by Ali et al, 7 an adult spinal deformity surgery population by Leven et al, 3,9 and surgical complications in patients undergoing lumbar and cervical fusion surgery. 3,[6][7][8][9] However, no previous studies have specifically addressed the utility of mFI in elderly patients undergoing spine surgery. This study is unique because it examines the ability of the mFI, once dichotomized, to prognosticate the outcome of spinal surgery in patients 80 years and older.…”

“…This is congruent with prior studies in spinal surgery, which have also showed comparable stepwise increases in morbidity and mortality as mFI increases. 3,[6][7][8][9] The ability of the mFI to risk stratify patients 80 years and older undergoing spinal surgery carries even greater significance because the ASA score, in an identical population, did not correlate with any of the postoperative outcome measures. 17,24,25 Previous studies evaluating the ASA score have shown varying results.…”

“…The wound infection rate also increased from 9.0% to 12.1% when the mFI rose from 0 to 3 variables (0 to 0.27) in the same cohort of patients. 5 The mFI has also been effective in predicting 30-day mortality and morbidity in patients undergoing spinal surgery, [5][6][7][8][9] although not in patients aged 80 years or older.…”

L5/S1 anterior lumbar interbody fusion technique

“…There are several patient characteristics and risk factors which significantly influence the clinical outcomes and complication rates of ALIF surgery. These include elderly age (12), worker's compensation status (13) and patient frailty (14). We did not find overweight or obesity (15), nor the presence of an "access surgeon" (16) as a significant factor contributing to ALIF outcomes.…”

Modified frailty index and body mass index as predictors of adverse surgical outcomes in degenerative spinal disease

“…Puvanesarajah et al mentioned the potential effect and relationship of elderly age with obesity on postoperative outcomes (19). Although some studies also viewed increasing age as a potential risk factor and an important predictor for poor postoperative outcome (17), other authors proposed that the chronologic age did not necessarily account for a weakened physiologic reserve or an increased vulnerability for an external stressor event independent of existing comorbidity and deficit accumulation. Previous studies also have shown that 75% of patients over 85 years old are physiologically robust (16,27).…”