A Comparison of Frailty Indices in Predicting Length of Inpatient Stay and Discharge Destination Following Angiogram-Negative Subarachnoid Hemorrhage
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.
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