Journal article
Comparison of the performance metrics of two frailty scales in spinal surgery: a systematic review and meta-analysis
Journal of neurosurgical sciences, v 70(2), pp 131-139
01 Apr 2026
PMID: 41734017
Featured in Collection : Drexel's Newest Publications
Abstract
The United States is experiencing a significant demographic shift characterized by an increasingly aging population, or "silver tsunami." These demographic changes have profound implications for spine surgery outcomes, as spinal surgery is one of the most frequent procedures performed annually by neurosurgeons and orthopedic spine surgeons. In current literature, two frailty indices, the Modified Frailty Index (mFI-5 or mFI-11) and the Risk Analysis Index (RAI), are the indices predominantly utilized to risk assess patients prior to surgical treatment. Utilizing a systematic search yielded ten studies. This study employs the area under the curve (AUC) from receiver operating characteristic (ROC) curves to develop a linear regression model aimed at evaluating the predictive performance of these indices for specific outcomes. This investigation focuses on the performance of the mFI and RAI in predicting three key postoperative outcomes in spine surgery patients: 30-day mortality, Clavien-Dindo IV complications, and non-home discharge (NHD). The results indicate that the RAI demonstrates superior predictive accuracy compared to the mFI for 30-day mortality (RAI AUC 0.82 [0.78-0.85] vs. mFI AUC 0.66 [0.62-0.70]) and Clavien-Dindo III-IV complications (RAI AUC 0.69 [0.66-0.72] vs. mFI AUC 0.63 [0.62-0.63]). However, no significant difference was observed in the ability to predict NHD (RAI AUC 0.81 [0.63, 0.91] vs. mFI AUC 0.71 [0.64, 0.77]). These findings suggest that the Risk Analysis Index is a more reliable predictor of 30-day mortality and Major complications (Clavien-Dindo III-IV) in patients undergoing spine surgery.
Metrics
1 Record Views
Details
- Title
- Comparison of the performance metrics of two frailty scales in spinal surgery: a systematic review and meta-analysis
- Creators
- Carmelo Venero Jr, Jr - University of KentuckyNiels Pacheco-Barrios - Brigham and Women's HospitalJoanna M Roy - Thomas Jefferson University HospitalStefan T Prvulovic - Georgetown UniversityGilberto Perez Rodriguez Garcia - University of ArizonaYusor Al-Nuaimy - Ajman UniversityAndre A Payman - Loyola University ChicagoAkshay Warrier - Rutgers, The State University of New JerseyFielding L Horne - University of KentuckyAryan Gajjar - University of California, Los AngelesHikmat R Chmait - University of VermontNithin Gupta - Campbell UniversitySanjeev Herr - Drexel University, College of MedicinePemla Jagtiani - SUNY Downstate Health Sciences UniversityDamian Sanchez - University of California at San Francisco, San Francisco, CA, USASina Zoghi - Shiraz University of Medical SciencesJaved Iqbal - University of Illinois ChicagoShubhang Bhalla - University of California, San FranciscoChristian A Bowers - Hurley Medical Center
- Publication Details
- Journal of neurosurgical sciences, v 70(2), pp 131-139
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- College of Medicine
- Web of Science ID
- WOS:001701558600001
- Scopus ID
- 2-s2.0-105034226417
- Other Identifier
- 991022176475504721
UN Sustainable Development Goals (SDGs)
This publication has contributed to the advancement of the following goals:
Source: SDGs in the Output
InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Clinical Neurology
- Surgery