Orthopedic Frailty Score and adverse outcomes in patients with surgically managed isolated traumatic spinal injury
Background With an aging global population, the prevalence of frailty in patients with traumatic spinal injury (TSI) is steadily increasing. The aim of the current study is to evaluate the utility of the Orthopedic Frailty Score (OFS) in assessing the risk of adverse outcomes in patients with isolat...
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BMJ Publishing Group
2024-11-01
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| Series: | Trauma Surgery & Acute Care Open |
| Online Access: | https://tsaco.bmj.com/content/9/1/e001265.full |
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| author | Yang Cao Shahin Mohseni Babak Sarani Frank Hildebrand Ahmad Mohammad Ismail Maximilian Peter Forssten Parker Chang Marcelo A F Ribeiro |
| author_facet | Yang Cao Shahin Mohseni Babak Sarani Frank Hildebrand Ahmad Mohammad Ismail Maximilian Peter Forssten Parker Chang Marcelo A F Ribeiro |
| author_sort | Yang Cao |
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| description | Background With an aging global population, the prevalence of frailty in patients with traumatic spinal injury (TSI) is steadily increasing. The aim of the current study is to evaluate the utility of the Orthopedic Frailty Score (OFS) in assessing the risk of adverse outcomes in patients with isolated TSI requiring surgery, with the hypothesis that frailer patients suffer from a disproportionately increased risk of these outcomes.Methods The Trauma Quality Improvement Program database was queried for all adult patients (18 years or older) who suffered an isolated TSI due to blunt force trauma, between 2013 and 2019, and underwent spine surgery. Patients were categorized as non-frail (OFS 0), pre-frail (OFS 1), or frail (OFS ≥2). The association between the OFS and in-hospital mortality, complications, and failure to rescue (FTR) was determined using Poisson regression models, adjusted for potential confounding.Results A total of 43 768 patients were included in the current investigation. After adjusting for confounding, frailty was associated with a more than doubling in the risk of in-hospital mortality (adjusted incidence rate ratio (IRR) (95% CI): 2.53 (2.04 to 3.12), p<0.001), a 25% higher overall risk of complications (adjusted IRR (95% CI): 1.25 (1.02 to 1.54), p=0.032), a doubling in the risk of FTR (adjusted IRR (95% CI): 2.00 (1.39 to 2.90), p<0.001), and a 10% increase in the risk of intensive care unit admission (adjusted IRR (95% CI): 1.10 (1.04 to 1.15), p=0.004), compared with non-frail patients.Conclusion The findings indicate that the OFS could be an effective method for identifying frail patients with TSIs who are at a disproportionate risk of adverse events.Level of evidence Level III. |
| format | Article |
| id | doaj-art-42c2f0344e8b4caeb6caefb0fd88a41c |
| institution | Kabale University |
| issn | 2397-5776 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | BMJ Publishing Group |
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| series | Trauma Surgery & Acute Care Open |
| spelling | doaj-art-42c2f0344e8b4caeb6caefb0fd88a41c2025-01-09T19:20:10ZengBMJ Publishing GroupTrauma Surgery & Acute Care Open2397-57762024-11-019110.1136/tsaco-2023-001265Orthopedic Frailty Score and adverse outcomes in patients with surgically managed isolated traumatic spinal injuryYang Cao0Shahin Mohseni1Babak Sarani2Frank Hildebrand3Ahmad Mohammad Ismail4Maximilian Peter Forssten5Parker Chang6Marcelo A F Ribeiro7Oncology Center, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China2 Department of Surgery, Sheikh Shakhbout Medical City—Mayo Clinic, Abu Dhabi, UAE7 George Washington University, Washington, District of Columbia, USA6 Department of Orthopedics, Trauma, and Reconstructive Surgery, University Hospital RWTH Aachen, Aachen, GermanySchool of Medical Sciences, Orebro University, Orebro, Sweden3 School of Medical Sciences, Örebro University, Orebro, Sweden6 Center for Trauma and Critical Care, The George Washington University, Washington, District of Columbia, USA7 Department of Surgery, Sheikh Shakhbout Medical City, Abu Dabi, Abu Dhabi, UAEBackground With an aging global population, the prevalence of frailty in patients with traumatic spinal injury (TSI) is steadily increasing. The aim of the current study is to evaluate the utility of the Orthopedic Frailty Score (OFS) in assessing the risk of adverse outcomes in patients with isolated TSI requiring surgery, with the hypothesis that frailer patients suffer from a disproportionately increased risk of these outcomes.Methods The Trauma Quality Improvement Program database was queried for all adult patients (18 years or older) who suffered an isolated TSI due to blunt force trauma, between 2013 and 2019, and underwent spine surgery. Patients were categorized as non-frail (OFS 0), pre-frail (OFS 1), or frail (OFS ≥2). The association between the OFS and in-hospital mortality, complications, and failure to rescue (FTR) was determined using Poisson regression models, adjusted for potential confounding.Results A total of 43 768 patients were included in the current investigation. After adjusting for confounding, frailty was associated with a more than doubling in the risk of in-hospital mortality (adjusted incidence rate ratio (IRR) (95% CI): 2.53 (2.04 to 3.12), p<0.001), a 25% higher overall risk of complications (adjusted IRR (95% CI): 1.25 (1.02 to 1.54), p=0.032), a doubling in the risk of FTR (adjusted IRR (95% CI): 2.00 (1.39 to 2.90), p<0.001), and a 10% increase in the risk of intensive care unit admission (adjusted IRR (95% CI): 1.10 (1.04 to 1.15), p=0.004), compared with non-frail patients.Conclusion The findings indicate that the OFS could be an effective method for identifying frail patients with TSIs who are at a disproportionate risk of adverse events.Level of evidence Level III.https://tsaco.bmj.com/content/9/1/e001265.full |
| spellingShingle | Yang Cao Shahin Mohseni Babak Sarani Frank Hildebrand Ahmad Mohammad Ismail Maximilian Peter Forssten Parker Chang Marcelo A F Ribeiro Orthopedic Frailty Score and adverse outcomes in patients with surgically managed isolated traumatic spinal injury Trauma Surgery & Acute Care Open |
| title | Orthopedic Frailty Score and adverse outcomes in patients with surgically managed isolated traumatic spinal injury |
| title_full | Orthopedic Frailty Score and adverse outcomes in patients with surgically managed isolated traumatic spinal injury |
| title_fullStr | Orthopedic Frailty Score and adverse outcomes in patients with surgically managed isolated traumatic spinal injury |
| title_full_unstemmed | Orthopedic Frailty Score and adverse outcomes in patients with surgically managed isolated traumatic spinal injury |
| title_short | Orthopedic Frailty Score and adverse outcomes in patients with surgically managed isolated traumatic spinal injury |
| title_sort | orthopedic frailty score and adverse outcomes in patients with surgically managed isolated traumatic spinal injury |
| url | https://tsaco.bmj.com/content/9/1/e001265.full |
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