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Role of Frailty Status in Prediction of Clinical Outcomes of Traumatic Spinal Injury: A Systematic Review and Meta-Analysis Publisher Pubmed



Rohollahi F1, 2 ; Farahbakhsh F2, 3 ; Kankam SB2, 3 ; Mohammadi M4 ; Mohammadi A4 ; Korkorian R4 ; Hobabi S4 ; Moarrefdezfouli A5 ; Molavi S2 ; Davies BM6 ; Zipser CM7 ; Laufer I8 ; Harrop J9 ; Arnold PM10, 11 Show All Authors
Authors
  1. Rohollahi F1, 2
  2. Farahbakhsh F2, 3
  3. Kankam SB2, 3
  4. Mohammadi M4
  5. Mohammadi A4
  6. Korkorian R4
  7. Hobabi S4
  8. Moarrefdezfouli A5
  9. Molavi S2
  10. Davies BM6
  11. Zipser CM7
  12. Laufer I8
  13. Harrop J9
  14. Arnold PM10, 11
  15. Martin AR12
  16. Rahimimovaghar V3
Show Affiliations
Authors Affiliations
  1. 1. Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
  4. 4. School of Medicine, Iran University of Medical Sciences, Tehran, Iran
  5. 5. Department of Cardiology, Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  6. 6. Division of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke’s Hospital, University of Cambridge, Cambridge, United Kingdom
  7. 7. Spinal Cord Injury Center, Balgrist University Hospital, Zurich, Switzerland
  8. 8. Department of Neurosurgery, NYU Grossman School of Medicine, New York, NY, United States
  9. 9. Department of Neurosurgery, Carle Foundation Hospital, Urbana, IL, United States
  10. 10. Carle Illinois College of Medicine, University of Illinois Urbana Champaign, Champaign, IL, United States
  11. 11. Division of Spine and Peripheral Nerve Surgery, Departments of Neurological and Orthopedic Surgery, Thomas Jefferson University, Philadelphia, PA, United States
  12. 12. Department of Neurological Surgery, University of California, Davis, CA, United States

Source: Journal of Neurotrauma Published:2023


Abstract

Although many frailty tools have been used to predict traumatic spinal injury (TSI) outcomes, identifying predictors of outcomes after TSI in the aged population is difficult. Frailty, age, and TSI association are interesting topics of discussion in geriatric literature. However, the association between these variables are yet to be clearly elucidated. We conducted a systematic review to investigate the association between frailty and TSI outcomes. The authors searched Medline, EMBASE, Scopus, and Web of Science for relevant studies. Studies with observational designs that assessed baseline frailty status in individuals suffering from TSI published from inception until 26th March 2023 were included. Length of hospital stay (LoS), adverse events (AEs), and mortality were the outcomes of interest. Of the 2425 citations, 16 studies involving 37,640 participants were included. The modified frailty index (mFI) was the most common tool used to assess frailty. Meta-analysis was employed only in studies that used mFI for measuring frailty. Frailty was significantly associated with increased in-hospital or 30-day mortality (pooled odds ratio [OR]: 1.93 [1.19; 3.11]), non-routine discharge (pooled OR: 2.44 [1.34; 4.44]), and AEs or complications (pooled OR: 2.00 [1.14; 3.50]). However, no significant relationship was found between frailty and LoS (pooled OR: 3.02 [0.86; 10.60]). Heterogeneity was observed across multiple factors, including age, injury level, frailty assessment tool, and spinal cord injury characteristics. In conclusion, although there is limited data concerning using frailty scales to predict short-term outcomes after TSI, the results showed that frailty status may be a predictor of in-hospital mortality, AEs, and unfavorable discharge destination. © Mary Ann Liebert, Inc.
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