• World Neurosurg · Jan 2020

    Frailty as a Predictor of Neurosurgical Outcomes in Brain Tumor Patients.

    • Tessa A Harland, Mary Wang, Dicle Gunaydin, Anthony Fringuello, Jacob Freeman, Patrick W Hosokawa, and D Ryan Ormond.
    • Department of Neurosurgery, University of Colorado School of Medicine, Aurora, Colorado, USA.
    • World Neurosurg. 2020 Jan 1; 133: e813-e818.

    BackgroundPreoperative risk assessment is important, but inexact because physiologic reserves are difficult to measure. When assessing quality of life for patients with brain tumors, having a better predictor of postsurgical outcome would be beneficial in counseling these patients. Frailty is thought to estimate physiologic reserves, and it has been found to predict postoperative complications, length of stay, and discharge to a skilled nursing facility or assisted living facility in patients undergoing various types of surgery. Frailty as an adjunct to preoperative assessment of neurosurgical patients has never been evaluated. This study aimed to determine whether frailty predicts neurosurgical complications in patients with brain tumors and enhances current perioperative risk models.MethodsFrailty was preoperatively assessed in 260 patients undergoing surgery for brain tumor resection using a validated scale that assessed weakness, weight loss, exhaustion, low physical activity, and slowed walking speed. Patients were classified as nonfrail (score of 0-1), moderately frail (score of 2-3), or frail (score of 4-5). Moderately frail and frail patients were combined for analysis.ResultsPreoperative frailty was associated with an increased risk for discharge to a location other than home (10.36; 95% confidence interval, 3.6-30.1), postoperative complications (2.09; 95% confidence interval, 1.09-3.98), and a longer length of stay (1.66; 95% confidence interval, 1.24-2.21).ConclusionsFrailty independently predicts discharge disposition, postoperative complications, and length of stay in patients undergoing surgery for brain tumor resection. Preoperative assessment of frailty can help neurosurgeons and patients make more informed decisions about pursing surgical treatment.Copyright © 2019 Elsevier Inc. All rights reserved.

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