Preoperative Frailty Score for 30-Day Morbidity and Mortality After Cranial Neurosurgery

Evaluating preoperative frailty is critical for guiding shared surgical decision-making. The purpose of this study was to develop a novel preoperative frailty index for classification of adverse outcomes following cranial neurosurgery procedures. The American College of Surgeons National Surgical Qu...

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Bibliographic Details
Published in:World neurosurgery 2017-11, Vol.107, p.959-965
Main Authors: Tomlinson, Samuel B., Piper, Keaton, Kimmell, Kristopher T., Vates, G. Edward
Format: Article
Language:English
Subjects:
ACS-NSQIP
Adult
Aged
Clinical Decision-Making - methods
Cranial neurosurgery
Databases, Factual - standards
Databases, Factual - trends
Female
Follow-Up Studies
Frailty - diagnosis
Frailty - mortality
Frailty - surgery
Frailty index
Humans
Male
Middle Aged
Morbidity
Mortality
Mortality - trends
Neurosurgical Procedures - adverse effects
Neurosurgical Procedures - mortality
Neurosurgical Procedures - trends
Postoperative Complications - mortality
Postoperative Complications - prevention & control
Preoperative Care - methods
Preoperative Care - standards
Quality Improvement - standards
Quality Improvement - trends
Retrospective Studies
Risk Factors
Surgical outcome
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Summary:Evaluating preoperative frailty is critical for guiding shared surgical decision-making. The purpose of this study was to develop a novel preoperative frailty index for classification of adverse outcomes following cranial neurosurgery procedures. The American College of Surgeons National Surgical Quality Improvement Program database was queried for all cranial neurosurgery cases from 2006 to 2014. Sequential univariate and multivariate testing was used to identify significant independent predictors of 30-day mortality. Frailty scores were computed by summating across weighted predictors. Receiver operating characteristic curve analysis quantified the discriminative capacity of the frailty score for classifying mortality and other major adverse outcomes. List-wise exclusion of patients with incomplete datasets yielded a final sample of 27,098 patients (mortality rate = 3.9%). Multivariate regression testing identified 19 independent predictors of 30-day mortality. Receiver operating characteristic curve analysis revealed impressive outcome discrimination (area under the curve = 0.87, P 
ISSN:1878-8750
1878-8769
DOI:10.1016/j.wneu.2017.07.081