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Perception of frailty in spinal metastatic disease: international survey of the AO Spine community.

Publication ,  Journal Article
MacLean, MA; Georgiopoulos, M; Charest-Morin, R; Goodwin, CR; Laufer, I; Dea, N; Shin, JH; Gokaslan, ZL; Rhines, LD; O'Toole, JE; Sciubba, DM ...
Published in: J Neurosurg Spine
March 3, 2023

OBJECTIVE: Frailty has not been clearly defined in the context of spinal metastatic disease (SMD). Given this, the objective of this study was to better understand how members of the international AO Spine community conceptualize, define, and assess frailty in SMD. METHODS: The AO Spine Knowledge Forum Tumor conducted an international cross-sectional survey of the AO Spine community. The survey was developed using a modified Delphi technique and was designed to capture preoperative surrogate markers of frailty and relevant postoperative clinical outcomes in the context of SMD. Responses were ranked using weighted averages. Consensus was defined as ≥ 70% agreement among respondents. RESULTS: Results were analyzed for 359 respondents, with an 87% completion rate. Study participants represented 71 countries. In the clinical setting, most respondents informally assess frailty and cognition in patients with SMD by forming a general perception based on clinical condition and patient history. Consensus was attained among respondents regarding the association between 14 preoperative clinical variables and frailty. Severe comorbidities, extensive systemic disease burden, and poor performance status were most associated with frailty. Severe comorbidities associated with frailty included high-risk cardiopulmonary disease, renal failure, liver failure, and malnutrition. The most clinically relevant outcomes were major complications, neurological recovery, and change in performance status. CONCLUSIONS: The respondents recognized that frailty is important, but they most commonly evaluate it based on general clinical impressions rather than using existing frailty tools. The authors identified numerous preoperative surrogate markers of frailty and postoperative clinical outcomes that spine surgeons perceived as most relevant in this population.

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Published In

J Neurosurg Spine

DOI

EISSN

1547-5646

Publication Date

March 3, 2023

Start / End Page

1 / 11

Location

United States

Related Subject Headings

  • Orthopedics
  • 3209 Neurosciences
  • 1109 Neurosciences
  • 1103 Clinical Sciences
 

Citation

APA
Chicago
ICMJE
MLA
NLM
MacLean, M. A., Georgiopoulos, M., Charest-Morin, R., Goodwin, C. R., Laufer, I., Dea, N., … AO Spine Knowledge Forum Tumor, . (2023). Perception of frailty in spinal metastatic disease: international survey of the AO Spine community. J Neurosurg Spine, 1–11. https://doi.org/10.3171/2023.1.SPINE221433
MacLean, Mark A., Miltiadis Georgiopoulos, Raphaële Charest-Morin, C Rory Goodwin, Ilya Laufer, Nicolas Dea, John H. Shin, et al. “Perception of frailty in spinal metastatic disease: international survey of the AO Spine community.J Neurosurg Spine, March 3, 2023, 1–11. https://doi.org/10.3171/2023.1.SPINE221433.
MacLean MA, Georgiopoulos M, Charest-Morin R, Goodwin CR, Laufer I, Dea N, et al. Perception of frailty in spinal metastatic disease: international survey of the AO Spine community. J Neurosurg Spine. 2023 Mar 3;1–11.
MacLean, Mark A., et al. “Perception of frailty in spinal metastatic disease: international survey of the AO Spine community.J Neurosurg Spine, Mar. 2023, pp. 1–11. Pubmed, doi:10.3171/2023.1.SPINE221433.
MacLean MA, Georgiopoulos M, Charest-Morin R, Goodwin CR, Laufer I, Dea N, Shin JH, Gokaslan ZL, Rhines LD, O’Toole JE, Sciubba DM, Fehlings MG, Stephens BF, Bettegowda C, Myrehaug S, Disch AC, Netzer C, Kumar N, Sahgal A, Germscheid NM, Weber MH, AO Spine Knowledge Forum Tumor. Perception of frailty in spinal metastatic disease: international survey of the AO Spine community. J Neurosurg Spine. 2023 Mar 3;1–11.

Published In

J Neurosurg Spine

DOI

EISSN

1547-5646

Publication Date

March 3, 2023

Start / End Page

1 / 11

Location

United States

Related Subject Headings

  • Orthopedics
  • 3209 Neurosciences
  • 1109 Neurosciences
  • 1103 Clinical Sciences