The Utility of the 5 Factor Modified Frailty Index in Outcome Prediction for Patients with Chronic Subdural Hematoma Treated with Surgical Drainage

Increasing frailty is a significant determinant of perioperative morbidity and mortality within neurosurgical literature. This study investigates the predictive value of the modified frailty index 5 (mFI-5) for postoperative morbidity and mortality following surgical drainage of chronic subdural hem...

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Bibliographic Details
Published in:World neurosurgery 2023-11, Vol.179, p.e328-e341
Main Authors: Zaki, Peter G., Bolger, John, Rogowski, Brandon, Busch, Nisha, Elhamdani, Shahed, Jeong, Seung, Li, Jenna, Leonardo, Jody, Williamson, Richard, Yu, Alexander, Shepard, Matthew J.
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Chronic subdural hematoma
Drainage
Frail Elderly
Frailty
Frailty - complications
Hematoma, Subdural, Chronic - complications
Hematoma, Subdural, Chronic - surgery
Humans
Middle Aged
Modified frailty index-5 (mFI-5)
Postoperative Complications - therapy
Retrospective Studies
Risk Assessment
Risk Factors
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Summary:Increasing frailty is a significant determinant of perioperative morbidity and mortality within neurosurgical literature. This study investigates the predictive value of the modified frailty index 5 (mFI-5) for postoperative morbidity and mortality following surgical drainage of chronic subdural hematoma (cSDH). A retrospective cohort study was performed on patients who underwent surgical evacuation of a cSDH. The mFI-5 score was calculated for each patient and used to stratify patients: prefrail (mFI-52). Multivariate Cox proportional hazards (CPH) regression analysis were used to identify factors associated with our primary outcomes: overall survival and 30-day readmission. Secondary outcomes included nonhome discharge, length of stay, hematoma accumulation, development of new postoperative neurologic deficits, resolution of preoperative neurologic deficits, and a modified Rankin score >2 at discharge. 118 patients with a mean age of 74.4 ± 11.9 years were analyzed. All baseline demographics were similar across the 3 groups. On multivariate analysis, severely frail patients (N = 24, 20.3%) had increased rates of 30-day readmission (hazard ratio [HR] 4.3, CPH regression P value
ISSN:1878-8750
1878-8769
1878-8769
DOI:10.1016/j.wneu.2023.08.085