Assessment of the incremental prognostic value from the modified frailty index‑5 in complete traumatic cervical spinal cord injury

Scientific Reports, 2023 · DOI: 10.1038/s41598-023-34708-5 · Published: May 5, 2023

Simple Explanation

This study investigates whether a measure of frailty (mFI-5) adds significant predictive information about in-hospital mortality for patients with complete cervical spinal cord injury, beyond what age alone can predict. The study found that while both age and frailty are independently associated with in-hospital mortality, the mFI-5 provides minimal additional prognostic value over age alone. This suggests that age is a stronger predictor of in-hospital mortality than frailty, as measured by mFI-5, in this specific patient population.

Study Duration

2010 to 2018

Participants

4733 adult complete cervical SCI patients

Evidence Level

Not specified

Key Findings

1
Both age and mFI-5 had statistically significant associations with in-hospital mortality.
2
There was no significant difference in the AUROC of a model including age and mFI-5 when compared to a model including age without mFI-5.
3
A model including age was superior to a model including mFI-5 without age.

Research Summary

This study assessed the incremental prognostic value of the modified frailty index-5 (mFI-5) over age in predicting in-hospital mortality among patients with complete traumatic cervical spinal cord injury (SCI). The study found that both age and frailty, as measured by mFI-5, are independently associated with increased in-hospital mortality. However, mFI-5 provides minimal additional prognostic value over age alone. The findings suggest that age is a stronger predictor of in-hospital mortality than frailty in patients with complete cervical SCI and may assist in counseling and triaging protocols.

Practical Implications

Patient Counseling

The results can help clinicians counsel patients and families regarding the risk of in-hospital mortality after complete cervical SCI, emphasizing the importance of age.

Treatment and Triaging

The study may inform the development of improved treatment and triaging protocols for spinal trauma, focusing on age as a key factor in risk assessment.

Future Research

Further research is needed to explore other measures of frailty and their potential incremental prognostic value in predicting outcomes after SCI.

Study Limitations

1
The observational and retrospective study design limits the ability to conclude causal effects between regression model covariates and in-hospital mortality.
2
The assessment of mortality was limited to the in-hospital trauma admission, potentially missing deaths occurring shortly after discharge.
3
The measurement of frailty was limited to the mFI-5, and other frailty measures may provide different results.

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