Frailty May Worsen Outcomes in Traumatic Spinal Cord Injury

Frailty is an important predictor of worse outcome after traumatic spinal cord injury (tSCI) in patients <75 years of age, according to a study recently published in the Journal of Neurotrauma.

Dan Banaszek, M.D., from the Vancouver Spine Surgery Institute at the University of British Columbia in Canada, and colleagues examined the effect of patient age, admission Total Motor Score (TMS), and Modified Frailty Index (mFI) on adverse events (AEs), acute length of stay (LOS), in-hospital mortality, and discharge destination (home versus other) among 634 patients with tSCI (2004 to 2016).

The researchers report that among the 634 identified patients, the mean age was 50.3 years, 77 percent were male, and falls were the main cause of injury (46.5 percent). mFI, age at injury, and TMS were predictors of AEs, acute LOS, and in-hospital mortality. In an adjusted analysis, mFI was a predictor of LOS (P = 0.0375) but not of AEs (P = 0.1428) or in-hospital mortality (P = 0.1245). mFI predicted number of AEs, acute LOS, and in-hospital mortality for patients <60 years of age. Among patients aged 61 to 75 years, TMS predicted AEs, LOS, and mortality, while among patients >76 years of age, mFI no longer predicted outcome.

"Identifying frailty in younger patients with tSCI may be useful for perioperative optimization, risk stratification, and patient counseling," the authors write.

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