External validation of the adult spinal deformity (ASD) frailty index (ASD-FI)

The European Spine Study Group, the International Spine Study Group

Research output: Contribution to journalArticle

Abstract

Purpose: To assess the ability of the recently developed adult spinal deformity frailty index (ASD-FI) to predict odds of perioperative complications, odds of reoperation, and length of hospital stay after adult spinal deformity (ASD) surgery using a database other than the one used to create the index. Methods: We used the ASD-FI to calculate frailty scores for 266 ASD patients who had minimum postoperative follow-up of 2 years in the European Spine Study Group (ESSG) database. Patients were enrolled from 2012 through 2013. Using ASD-FI scores, we categorized patients as not frail (NF) (< 0.3 points), frail (0.3–0.5 points), or severely frail (SF) (> 0.5 points). Multivariable logistic regression, adjusted for preoperative and surgical factors such as operative time and blood loss, was performed to determine the relationship between ASD-FI category and odds of major complications, odds of reoperation, and length of hospital stay. Results: We categorized 135 patients (51%) as NF, 90 patients (34%) as frail, and 41 patients (15%) as SF. Overall mean ASD-FI score was 0.29 (range 0–0.8). The adjusted odds of experiencing a major intraoperative or postoperative complication (OR 4.5, 95% CI 2.0–10) or having a reoperation (OR 3.9, 95% CI 1.7–8.9) were higher for SF patients compared with NF patients. Mean hospital stay was 2.1 times longer (95% CI 1.8–2.4) for SF patients compared with NF patients. Conclusions: Greater patient frailty, as measured by the ASD-FI, is associated with longer hospital stays and greater odds of major complications and reoperation. Graphical abstract: These slides can be retrieved under Electronic Supplementary Material.[Figure not available: see fulltext.]

Original languageEnglish (US)
Pages (from-to)1-8
Number of pages8
JournalEuropean Spine Journal
DOIs
StateAccepted/In press - Mar 30 2018

Fingerprint

Length of Stay
Reoperation
Databases
Intraoperative Complications
Operative Time
Spine
Logistic Models

Keywords

  • Adult spinal deformity
  • Comorbidities
  • Complications
  • Frailty index
  • Functional status
  • Preoperative risk stratification

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

The European Spine Study Group, & the International Spine Study Group (Accepted/In press). External validation of the adult spinal deformity (ASD) frailty index (ASD-FI). European Spine Journal, 1-8. https://doi.org/10.1007/s00586-018-5575-3

External validation of the adult spinal deformity (ASD) frailty index (ASD-FI). / The European Spine Study Group; the International Spine Study Group.

In: European Spine Journal, 30.03.2018, p. 1-8.

Research output: Contribution to journalArticle

The European Spine Study Group ; the International Spine Study Group. / External validation of the adult spinal deformity (ASD) frailty index (ASD-FI). In: European Spine Journal. 2018 ; pp. 1-8.
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abstract = "Purpose: To assess the ability of the recently developed adult spinal deformity frailty index (ASD-FI) to predict odds of perioperative complications, odds of reoperation, and length of hospital stay after adult spinal deformity (ASD) surgery using a database other than the one used to create the index. Methods: We used the ASD-FI to calculate frailty scores for 266 ASD patients who had minimum postoperative follow-up of 2 years in the European Spine Study Group (ESSG) database. Patients were enrolled from 2012 through 2013. Using ASD-FI scores, we categorized patients as not frail (NF) (< 0.3 points), frail (0.3–0.5 points), or severely frail (SF) (> 0.5 points). Multivariable logistic regression, adjusted for preoperative and surgical factors such as operative time and blood loss, was performed to determine the relationship between ASD-FI category and odds of major complications, odds of reoperation, and length of hospital stay. Results: We categorized 135 patients (51{\%}) as NF, 90 patients (34{\%}) as frail, and 41 patients (15{\%}) as SF. Overall mean ASD-FI score was 0.29 (range 0–0.8). The adjusted odds of experiencing a major intraoperative or postoperative complication (OR 4.5, 95{\%} CI 2.0–10) or having a reoperation (OR 3.9, 95{\%} CI 1.7–8.9) were higher for SF patients compared with NF patients. Mean hospital stay was 2.1 times longer (95{\%} CI 1.8–2.4) for SF patients compared with NF patients. Conclusions: Greater patient frailty, as measured by the ASD-FI, is associated with longer hospital stays and greater odds of major complications and reoperation. Graphical abstract: These slides can be retrieved under Electronic Supplementary Material.[Figure not available: see fulltext.]",
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AU - the International Spine Study Group

AU - Miller, Emily K.

AU - Vila-Casademunt, Alba

AU - Neuman, Brian J

AU - Sciubba, Daniel

AU - Kebaish, Khaled M

AU - Smith, Justin S.

AU - Alanay, Ahmet

AU - Acaroglu, Emre R.

AU - Kleinstück, Frank

AU - Obeid, Ibrahim

AU - Sánchez Pérez-Grueso, Francisco Javier

AU - Carreon, Leah Y.

AU - Schwab, Frank J.

AU - Bess, Shay

AU - Scheer, Justin K.

AU - Lafage, Virginie

AU - Shaffrey, Christopher I.

AU - Pellisé, Ferran

AU - Ames, Christopher P.

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N2 - Purpose: To assess the ability of the recently developed adult spinal deformity frailty index (ASD-FI) to predict odds of perioperative complications, odds of reoperation, and length of hospital stay after adult spinal deformity (ASD) surgery using a database other than the one used to create the index. Methods: We used the ASD-FI to calculate frailty scores for 266 ASD patients who had minimum postoperative follow-up of 2 years in the European Spine Study Group (ESSG) database. Patients were enrolled from 2012 through 2013. Using ASD-FI scores, we categorized patients as not frail (NF) (< 0.3 points), frail (0.3–0.5 points), or severely frail (SF) (> 0.5 points). Multivariable logistic regression, adjusted for preoperative and surgical factors such as operative time and blood loss, was performed to determine the relationship between ASD-FI category and odds of major complications, odds of reoperation, and length of hospital stay. Results: We categorized 135 patients (51%) as NF, 90 patients (34%) as frail, and 41 patients (15%) as SF. Overall mean ASD-FI score was 0.29 (range 0–0.8). The adjusted odds of experiencing a major intraoperative or postoperative complication (OR 4.5, 95% CI 2.0–10) or having a reoperation (OR 3.9, 95% CI 1.7–8.9) were higher for SF patients compared with NF patients. Mean hospital stay was 2.1 times longer (95% CI 1.8–2.4) for SF patients compared with NF patients. Conclusions: Greater patient frailty, as measured by the ASD-FI, is associated with longer hospital stays and greater odds of major complications and reoperation. Graphical abstract: These slides can be retrieved under Electronic Supplementary Material.[Figure not available: see fulltext.]

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KW - Adult spinal deformity

KW - Comorbidities

KW - Complications

KW - Frailty index

KW - Functional status

KW - Preoperative risk stratification

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