Back to Search
Start Over
Prospective application of the risk analysis index to measure preoperative frailty in spinal tumor surgery: A single center outcomes analysis
- Source :
- World Neurosurgery: X, Vol 19, Iss , Pp 100203- (2023)
- Publication Year :
- 2023
- Publisher :
- Elsevier, 2023.
-
Abstract
- Introduction: Surgeons are frequently faced with challenging clinical dilemmas evaluating whether the benefits of surgery outweigh the substantial risks routinely encountered with spinal tumor surgery. The Clinical Risk Analysis Index (RAI-C) is a robust frailty tool administered via a patient-friendly questionnaire that strives to augment preoperative risk stratification. The objective of the study was to prospectively measure frailty with RAI-C and track postoperative outcomes after spinal tumor surgery. Methods: Patients surgically treated for spinal tumors were followed prospectively from 7/2020–7/2022 at a single tertiary center. RAI-C was ascertained during preoperative visits and verified by the provider. The RAI-C scores were assessed in relation to postoperative functional status (measured by modified Rankin Scale score [mRS]) at the last follow-up visit. Results: Of 39 patients, 47% were robust (RAI 0–20), 26% normal (21–30), 16% frail (31–40), and 11% severely frail (RAI 41+).). Pathology included primary (59%) and metastatic (41%) tumors with corresponding mRS>2 rates of 17% and 38%, respectively. Tumors were classified as extradural (49%), intradural extramedullary (46%), or intradural intramedullary (5.4%) with mRS>2 rates of 28%, 24%, and 50%, respectively. RAI-C had a positive association with mRS>2 at follow-up: 16% for robust, 20% for normal, 43% for frail, and 67% for severely frail. The two deaths in the series had the highest RAI-C scores (45 and 46) and were patients with metastatic cancer. The RAI-C was a robust and diagnostically accurate predictor of mRS>2 in receiver operating characteristic curve analysis (C-statistic: 0.70, 95 CI: 0.49–0.90). Conclusions: The findings exemplify the clinical utility of RAI-C frailty scoring for prediction of outcomes after spinal tumor surgery and it has potential to help in the surgical decision-making process as well as surgical consent. As a preliminary case series, the authors intend to provide additional data with a larger sample size and longer follow-up duration in a future study.
Details
- Language :
- English
- ISSN :
- 25901397
- Volume :
- 19
- Issue :
- 100203-
- Database :
- Directory of Open Access Journals
- Journal :
- World Neurosurgery: X
- Publication Type :
- Academic Journal
- Accession number :
- edsdoj.f932225db18446f1836d6abc6bc5e620
- Document Type :
- article
- Full Text :
- https://doi.org/10.1016/j.wnsx.2023.100203