NYMC Faculty Publications
A Comparison of Frailty Indices in Predicting Length of Inpatient Stay and Discharge Destination Following Angiogram-Negative Subarachnoid Hemorrhage
Author Type(s)
Faculty
DOI
10.1080/02688697.2020.1781056
Journal Title
British Journal of Neurosurgery
First Page
402
Last Page
407
Document Type
Article
Publication Date
8-2021
Department
Neurosurgery
Second Department
Neurology
Keywords
Angiography, Frailty, Humans, Inpatients, Length of Stay, Middle Aged, Patient Discharge, Postoperative Complications, Retrospective Studies, Subarachnoid Hemorrhage
Disciplines
Medicine and Health Sciences
Abstract
BACKGROUND AND PURPOSE: While patients with angiogram-negative subarachnoid hemorrhages (ANSAH) have better prognoses than those with aneurysmal SAH, frailty's impact on outcomes in ANSAH is unclear. We previously showed that the modified frailty index (mFI-11) is associated with poor outcomes following ANSAH. Here, we compared the mFI-5, mFI-11, Charlson Comorbidity Index (CCI), and temporalis thickness (TMT) to determine which index was the best predictor of ANSAH outcomes and mortality rates.
METHODS: In this retrospective cohort analysis between 2014 and 2018, patients with non-traumatic, angiogram negative SAH (ANSAH) were identified. The admission mFI-5, mFI-11, CCI, and TMT were calculated for each patient. Primary outcomes were mortality rate, discharge location, and prolonged length of stay (PLOS; LOS >85
RESULTS: We included 75 patients with a mean age of 55.4 ± 1.5 years. There were 4 patient deaths (5.3%), 53 patients (70.7%) discharged home, and 11 patients (14.7%) with PLOS. On ROC analysis, the mFI-5 had the highest discriminatory value for mortality (AUC
CONCLUSIONS: Increasing frailty is associated with poorer outcomes and higher mortality following ANSAH. The mFI-5 and mFI-11 were found to be superior predictors of discharge home and mortality rate. While larger prospective study is needed, frailty, as measured by mFI-11 and -5, should be considered when evaluating ANSAH prognosis.
Recommended Citation
McIntyre, M. K., Gandhi, C., Dragonette, J., Schmidt, M., Cole, C., Santarelli, J., Lehrer, R., Al-Mufti, F., & Bowers, C. A. (2021). A Comparison of Frailty Indices in Predicting Length of Inpatient Stay and Discharge Destination Following Angiogram-Negative Subarachnoid Hemorrhage. British Journal of Neurosurgery, 35 (4), 402-407. https://doi.org/10.1080/02688697.2020.1781056
