Frailty Indexes in Metastatic Spine Tumor Surgery: A Narrative Review

Quantification of preoperative frailty is an important prognostic tool in neuro-surgical decision making. Metastatic spine tumor patients undergoing surgery are frail and have unfavorable outcomes that include an increased length of stay, unfavorable discharge disposition, and increased readmission rates. These un-desirable outcomes result in higher treatment costs. A heterogeneous mixture of various frailty indexes is available with marked variance in their validation, leading to disparate clinical utility. The lack of a universally accepted definition for frailty, let alone in the method of creation or elements required in the for-mation of a frailty index, has resulted in a body of frailty literature lacking precision for predicting neurosurgical outcomes. In this review, we examine the role of reported frailty indexes in predicting postoperative outcomes after resection of metastatic spine tumors and aim to assist as a frailty guide for helping clinical decision making.

Automated summary

Preoperative frailty quantification is crucial in neuro-surgical decision making. Patients with metastatic spine tumors undergoing surgery are frail and experience unfavorable outcomes, leading to increased treatment costs. The lack of a universally accepted definition for frailty and variation in validation of frailty indexes result in imprecise predictions for neurosurgical outcomes. This review examines the role of reported frailty indexes in predicting postoperative outcomes and aims to assist clinical decision making as a frailty guide.