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Frailty is not an independent risk factor for worse clinical outcomes in lumbar spinal surgery: a prospective cohort study

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Abstract

Purpose

Recently, many studies revealed that frailty affects unfavorably on postoperative outcomes in lumbar spinal diseases. This study aimed to investigate the relationship between frailty and clinical outcomes while identifying risk factors associated with worse clinical outcomes following lumbar spinal surgery.

Methods

From March 2019 to February 2021, we prospectively enrolled eligible patients with degenerative lumbar spinal diseases requiring surgery. Frailty was assessed preoperatively. To identify the impact of frailty on lumbar spinal diseases, clinical outcomes, which were measured with patient-reported outcomes (PROs) and postoperative complications, were compared according to the frailty. PROs were assessed preoperatively and one year postoperatively. In addition, risk factors for preoperative and postoperative worse clinical outcomes were investigated.

Results

PROs were constantly lower in the frail group than in the non-frail group before and after surgery, and the change of PROs between before and after surgery and postoperative complications were not different between the groups. In addition, frailty was a persistent risk factor for postoperative worse clinical outcome before and after surgery in lumbar spinal surgery.

Conclusion

Frailty persistently affects the clinical outcome negatively before and after surgery in lumbar spinal surgery. However, as the change of the clinical outcome is not different between the frail group and the non-frail group, it is difficult to interpret whether the frail patients are vulnerable to the surgery. In conclusion, frailty is not an independent risk factor for worse clinical outcome in lumbar spinal surgery.

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Acknowledgments

This study was supported by a grant (2018OM1085) from the Asan Institute for Life Science, Asan Medical Center, Seoul, Republic of Korea.

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Author notes

  1. Hong Kyung Shin and Ji Yeon Baek contributed equally to this work.

Authors and Affiliations

  1. Department of Neurological Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea

    Hong Kyung Shin, Jeoung Hee Kim, Danbi Park, Sang Ryong Jeon, Sung Woo Roh & Jin Hoon Park

  2. Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea

    Ji Yeon Baek & Il-Young Jang

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  1. Hong Kyung Shin
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Correspondence to Jin Hoon Park.

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Shin, H.K., Baek, J.Y., Kim, J.H. et al. Frailty is not an independent risk factor for worse clinical outcomes in lumbar spinal surgery: a prospective cohort study. Eur Spine J (2024). https://doi.org/10.1007/s00586-024-08202-z

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