Type 2 odontoid fractures (T2OF), defined by fracture through base of dens, account
for ∼50% odontoid fractures and usually result in cervical instability [
[1]
]. There is lack of consensus regarding which patients are appropriate for nonoperative
(external immobilization) versus operative (surgical fixation, multiple approaches)
management [
[1]
]. Many surgeons lean towards nonoperative management in elderly patients [
[1]
]. However, nonunion rates with brace therapy increase significantly with age and some
elderly patients poorly tolerate external immobilization therapy [
[1]
]. Frailty is a measure of physiological reserve and valuable risk stratification tool
in the preoperative setting. The Risk Analysis Index (RAI) is a robust index based
on accumulation of deficits model of frailty [
[2]
,
[3]
]. However, the clinical utility of RAI in patients with T2OF is unclear [
[4]
]. The aim of the present study was to analyze the prognostic significance of preoperative
frailty, as measured by RAI, with 30-day mortality after surgical treatment of T2OF
using the American College of Surgeons National Surgical Quality Improvement Program
(ACS-NSQIP) database, 2015-2020.Keywords
Abbreviations:
ACS-NSQIP (American College of Surgeons National Surgical Quality Improvement Database), mFI (modified Frailty Index), RAI (Risk Analysis Index), T2OF (Type II Odontoid Fracture)To read this article in full you will need to make a payment
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References
- Odontoid fractures.StatPearls. StatPearls Publishing, 2022 (Accessed August 8, 2022. Available at:)
- Development and initial validation of the risk analysis index for measuring frailty in surgical populations.JAMA Surg. 2017; 152: 175-182
- Recalibration and External Validation of the Risk Analysis Index: a Surgical Frailty Assessment Tool.Ann Surg. 2020; 272: 996-1005
- The immense heterogeneity of frailty in neurosurgery: a systematic literature review.Neurosurg Rev. 2021; 44: 189-201
- Assessing frailty in neurosurgical patients: less is not always more. Is there any construct validity left in the modified frailty index?.Neurosurgery. 2021; 88: E292-E293
- Clinical utility of the risk analysis index as a prospective frailty screening tool within a multi-practice, multi-hospital integrated healthcare system.Ann Surg. 2021; 274: e1230-e1237
- The contribution of benchmarking to quality improvement in healthcare. A systematic literature review.BMC Health Serv Res. 2022; 22: 139https://doi.org/10.1186/s12913-022-07467-8
Article info
Publication history
Published online: February 15, 2023
Accepted:
February 6,
2023
Received in revised form:
January 30,
2023
Received:
September 11,
2022
Footnotes
FDA device/drug status: Not applicable
Author disclosure: KR: Nothing to disclose. SFK: Nothing to disclose. PJ: Nothing to disclose. RGM: Nothing to disclose. MHS: Nothing to disclose. CAB: Nothing to disclose.
Identification
Copyright
© 2023 Elsevier Inc. All rights reserved.
