Introduction: Frailty refers to a state of weakness, which can arise due to age or illnesses, and it predisposes one to several adverse health outcomes. This has been postulated to prognosticate the outcome of various surgeries including surgeries for various spine conditions however no meta-analysis has validated this.
Methods: We conducted a systematic review and meta-analysis to investigate the prognostic utility of frailty on the outcome of spine surgeries. We performed a systematic search in PubMed, EMBASE, and SCOPUS databases for studies investigating the ability of frailty to prognosticate the outcome of spine surgeries. We analyze the role high frailty using m-5FI on outcomes [extended Length of stay, Readmission, postoperative complications, in-hospital mortality, reoperation, and nonroutine discharge ] of spine surgeries
Results: Meta-analysis of the information provided in the Eleven studies that made up our sample size of 89,137; all studies set m-5FI ≥ 2 as their cutoff for high frailty; most studies are done in the United States based on the ACS-NSQIP database. Outcome of our analysis are extended hospital length of stay [LOS] (Effect size 1.64; 95% confidence interval [CI]: 1.49, 1.79), postoperative complications (Effect size 1.49; 95% CI: 1.10, 1.88), readmission (Effect size 1.69; 95% CI: 1.40, 1.99), nonroutine discharge (Effect size 2.16; 95% CI: 1.80, 2.51), postoperative in-hospital mortality (Effect size 2.11; 95% CI: 1.25, 2.96), and reoperation (Effect size 1.32; 95% CI: 1.19, 1.45).
Conclusion : This study shows that high frailty using modified 5-Item Frailty Index is correlated with increase risk of readmission, extended length of hospital stay, postoperative complications, nonroutine discharge, postoperative in-hospital mortality, and reoperation following spine surgeries for any spine’s pathology
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