The impact of frailty on postoperative complications in geriatric patients undergoing multi-level lumbar fusion surgery

Frailty is a Risk Factor for Postoperative Complications in Older Adults with Lumbar Degenerative Disease: A Prospective Cohort Study

“…Additionally, our subgroup analysis demonstrated no statistically significant difference in the incidence of postoperative complications in the frail group and the non-frail group when comparing TLIF and MIS-TLIF surgery, while the research of Ton et al 43 indicated frail patients who underwent multi-level lumbar fusions using a traditional open approach experienced a higher rate of surgical complications compared to other frail patients who underwent the same procedure using an MIS techniques. These findings offer orthopedic surgeons valuable insights into the potential benefits of minimally invasive techniques for older adults undergoing lumbar fusion surgery, especially those identified as frail.…”

Developing Mixed-Effects Models to Compare the Predictive Ability of Various Comorbidity Indices in a Contemporary Cohort of Patients Undergoing Lumbar Fusion

“…Among these influential factors are age, [12][13][14] the presence or absence of modifiable risk factors (malnutrition and obesity), [15][16][17][18] and any relevant nonmodifiable factors (such as patient frailty status). 6,7,19 Along these lines, several comorbidity indices-including the Elixhauser Comorbidity Index (ECI) and various other indices that can serve as proxies for patient frailty status (ie, the Johns Hopkins Adjusted Clinical Groups [JHACG] indicator)-have been developed in recent years to aid in prognostication efforts. [20][21][22][23] However, their comparative ability to predict outcomes after lumbar spinal fusion is less clear.…”

“…Among these influential factors are age, 12-14 the presence or absence of modifiable risk factors (malnutrition and obesity), 15-18 and any relevant nonmodifiable factors (such as patient frailty status). 6,7,19…”

“…Despite established efficacy for well-selected patients, 3 lumbar spinal fusion can be associated with complications including postoperative infection, poor wound healing, intraoperative blood loss, postoperative hematoma, neurological deficit, cerebrospinal fluid leak, thromboembolism, injury to surrounding structures, adjacent segment degeneration, and nonunion potentially requiring reoperation. [4][5][6][7][8][9] Given these risks, a rigorous approach to operative patient selection is central to achieving optimal outcomes. Moreover, the implications of proper patient selection are not limited to the direct physical effects of surgery on the patient.…”

“…Despite established efficacy for well-selected patients, 3 lumbar spinal fusion can be associated with complications including postoperative infection, poor wound healing, intraoperative blood loss, postoperative hematoma, neurological deficit, cerebrospinal fluid leak, thromboembolism, injury to surrounding structures, adjacent segment degeneration, and nonunion potentially requiring reoperation. 4-9…”