Prevalence and Influence of Frailty on Hospital Outcomes After Surgical Resection of Spinal Meningiomas

-OBJECTIVE: Frailty has been shown to affect patient outcomes after medical and surgical interventions. The Hospital Frailty Risk Score (HFRS) is a growing metric used to assess patient frailty using International Classification of Diseases, Tenth Revision codes. The goal of this study was to investigate the impact of frailty, assessed by HFRS, on health care resource utilization and outcomes in pa-tients undergoing surgery for spinal meningiomas. METHODS: A retrospective cohort study was performed using the 2016e2019 National Inpatient Sample database. Adult patients with benign or malignant spinal meningi-omas, identified using International Classification of Dis-eases, Tenth Revision, Clinical Modification codes, were stratified by HFRS: low frailty (HFRS <5) and intermediate -high frailty (HFRS double dagger 5). Patient demographics, hospital characteristics, comorbidities, procedural variables, adverse events, length of stay (LOS), discharge disposition, and cost of admission were assessed. Multivariate regression analysis was used to identify predictors of increased LOS, discharge disposition, and cost. -RESULTS: Of the 3345 patients, 530 (15.8%) had intermediate-high frailty. The intermediate-high cohort was significantly older (P < 0.001). More patients in the intermediate-high cohort had double dagger 3 comorbidities (P < 0.001). In addition, a greater proportion of patients in the intermediate-high cohort experienced double dagger 1 perioperative adverse events (P < 0.001). Intermediate-high patients experienced greater mean LOS (P < 0.001) and accrued greater costs (P < 0.001). A greater proportion of intermediate-high patients had nonroutine discharges (P < 0.001). On multivariate analysis, increased HFRS (double dagger 5) was independently associated with extended LOS (adjusted odds ratio [aOR], 3.04; P < 0.001), nonroutine discharge (aOR, 1.98; P = 0.006), and increased costs (aOR, 2.39; P = 0.004).CONCLUSIONS: Frailty may be associated with increased health care resource utilization in patients un-dergoing surgery for spinal meningiomas.