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PMID- 28894682
OWN - NLM
STAT- PubMed-not-MEDLINE
DA  - 20170912
LR  - 20170914
IS  - 2192-5682 (Print)
IS  - 2192-5682 (Linking)
VI  - 7
IP  - 6
DP  - 2017 Sep
TI  - Frailty Is Predictive of Adverse Postoperative Events in Patients Undergoing
      Lumbar Fusion.
PG  - 529-535
LID - 10.1177/2192568217700099 [doi]
AB  - STUDY DESIGN: Retrospective study of prospectively collected data. OBJECTIVE: To 
      analyze the modified frailty index (mFI) as a predictor of adverse postoperative 
      events following posterior lumbar fusion. METHODS: The American College of
      Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database
      including all adult patients undergoing posterior lumbar interbody fusion or
      transforaminal lumbar interbody fusion between 2005 and 2012. Outcomes measured
      included mortality, postoperative complications, length of stay, reoperations,
      and readmissions. The previously described mFI was calculated, and univariate and
      multivariate logistic regression analysis were used to analyze risk factors
      associated with morbidity, mortality, and adverse postoperative events. This
      study was qualified as exempt by the Mount Sinai Hospital Institutional Review
      Board. RESULTS: A total of 6094 patients met inclusion criteria. The mean mFI was
      0.087(0-0.545). Increasing mFI score was associated with increased complications,
      reoperations, prolonged length of stay (LOS), and morbidity (P < .05). As the mFI
      score increased from 0.27 (3/11 variables present) to >/=0.36 (4/11), the rate of
      any complication increased from 26.8% to 35% (P < .0001), sepsis 2.4% to 5.2% (P 
      < .0001), wound complications 4.4% to 6.5% (P < .0001), unplanned readmissions
      4.7% to 20% (P = .02), and urinary tract infection 4.1% to 10.4% (P < .0001). An 
      mFI of >/=0.36 was an independent predictor of any complication (odds ratio [OR]=
      2.2, 95% confidence interval [CI] = 1.3-3.7), sepsis (OR = 6.3, 95%, CI =
      1.8-21), wound complications (OR = 2.9, 95% CI = 1.1-8.2), prolonged LOS (OR =
      2.3, 95% CI = 1.4-3.7), and readmission (OR = 4.3, 95% CI = 1.5-12.7).
      CONCLUSION: Patients with higher mFI scores (>/= 4/11 variables) are at a
      significantly higher risk of major complications, readmissions, and prolonged LOS
      following lumbar fusion.
FAU - Leven, Dante M
AU  - Leven DM
AD  - Icahn School of Medicine at Mount Sinai, New York, NY, USA.
FAU - Lee, Nathan J
AU  - Lee NJ
AD  - Icahn School of Medicine at Mount Sinai, New York, NY, USA.
FAU - Kim, Jun S
AU  - Kim JS
AD  - Icahn School of Medicine at Mount Sinai, New York, NY, USA.
FAU - Kothari, Parth
AU  - Kothari P
AD  - Icahn School of Medicine at Mount Sinai, New York, NY, USA.
FAU - Steinberger, Jeremy
AU  - Steinberger J
AD  - Icahn School of Medicine at Mount Sinai, New York, NY, USA.
FAU - Guzman, Javier
AU  - Guzman J
AD  - Icahn School of Medicine at Mount Sinai, New York, NY, USA.
FAU - Skovrlj, Branko
AU  - Skovrlj B
AD  - Icahn School of Medicine at Mount Sinai, New York, NY, USA.
FAU - Shin, John I
AU  - Shin JI
AD  - Icahn School of Medicine at Mount Sinai, New York, NY, USA.
FAU - Phan, Kevin
AU  - Phan K
AD  - Prince of Wales Private Hospital, Sydney, New South Wales, Australia.
AD  - University of New South Wales, Sydney, Sydney, New South Wales, Australia.
FAU - Caridi, John M
AU  - Caridi JM
AD  - Icahn School of Medicine at Mount Sinai, New York, NY, USA.
FAU - Cho, Samuel K
AU  - Cho SK
AD  - Icahn School of Medicine at Mount Sinai, New York, NY, USA.
LA  - eng
PT  - Journal Article
DEP - 20170516
PL  - England
TA  - Global Spine J
JT  - Global spine journal
JID - 101596156
PMC - PMC5582713
OTO - NOTNLM
OT  - National Surgical Quality Improvement Program
OT  - frailty index
OT  - morbidity
OT  - mortality
OT  - posterior lumbar fusion
COI - Declaration of Conflicting Interests: The author(s) declared the following
      potential conflicts of interest with respect to the research, authorship, and/or 
      publication of this article: SKC has received funding from Stryker and OREF
      outside the submitted work. All other authors declare no conflicts of interest.
EDAT- 2017/09/13 06:00
MHDA- 2017/09/13 06:01
CRDT- 2017/09/13 06:00
AID - 10.1177/2192568217700099 [doi]
AID - 10.1177_2192568217700099 [pii]
PST - ppublish
SO  - Global Spine J. 2017 Sep;7(6):529-535. doi: 10.1177/2192568217700099. Epub 2017
      May 16.