A High Frailty Burden is a Strong Predictor of Adverse Postoperative Outcomes in Geriatric Lumbar Spine Surgery: A Retrospective Cohort Study
Jaein Cho, Hyun-Chang Kim, Do-Hyeong Kim, Hye Sun Lee, Hana Choe, Myoung Hwa KimStudy Design
Retrospective cohort study.
Objectives
To determine whether the 5-item modified frailty index (mFI-5) is associated with in-hospital complications and 1-year adverse events among patients aged ≥70 years who underwent lumbar spine surgery.
Methods
We retrospectively reviewed data from patients aged ≥70 years who underwent lumbar spine surgery at a single tertiary referral hospital from January 2020 to December 2021, with 1-year follow-up. Participants were stratified into two groups based on an mFI-5 score of 3. The primary outcome was the odds of in-hospital complications, and the secondary outcome was the odds of 1-year adverse events. To account for confounding variables and identify independent predictors, we applied inverse probability of treatment weighting (IPTW) and multivariable logistic regression.
Results
Among 967 eligible older adults, 132 (13.6%) met the criteria for severe frailty (mFI-5 score ≥3). Following IPTW adjustment, severe frailty was significantly and independently associated with in-hospital complications (odds ratio: 1.792, 95% confidence interval: 1.243–2.585;
Conclusion
Severe frailty was independently associated with in-hospital complications in older adults undergoing lumbar spine surgery. The mFI-5 may serve as a practical tool for stratifying preoperative surgical risk and tailoring perioperative management.