Aim:The aim of this study is to reveal the potential relationships and interactive effects between frailty and body weight on adverse surgical outcomes for degenerative spinal disease.
Material and Methods:Patients who underwent open surgery for degenerative spinal disease in our hospital were included. Data on the patients and diseases variables was obtained. The primary independent variables included body mass index (BMI) and modified Frailty Index (mFI). The primary outcome was the Clavien-Dindo complications classification. After univariate analyses, multinomial and ordinal regression analyses were applied with the Clavien-Dindo complications grade as the dependent variable and the potential risk factors for complications as independent variables, respectively, to determine the potential interactive relationship between the two primary risk factors and their impact on postoperative complications grading.
Results:A total of 1970 patients were included in the study. The results showed that underweight could significantly increase the odds ratios of prefrail and frail at the same time; however, obese could only increase the odds ratio of frail. The underweight, obese, prefrail and frail subgroups could significantly increase the grading of postoperative complications, respectively. If mFI and BMI were combined as an interactive viable, the results showed that in the underweight and normal weight subgroups, both prefrail and frail could significantly increase the grading of postoperative complications; however, in the overweight and obese subgroups, only the overweight/frail, obese/non-frail and obese/frail subgroups displayed significantly increased grading of postoperative complications.
Conclusion:The present results serve to stratify susceptible patients with easily identified risk factors preoperatively.