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Multicenter Study
. 2024 Oct;170(1):89-100.
doi: 10.1007/s11060-024-04780-6. Epub 2024 Sep 4.

Frailty indices predict mortality, complications and functional improvements in supratentorial meningioma patients over 80 years of age

Christoph Schwartz  1   2 , Moritz F Ueberschaer  3 , Ilari Rautalin  4   5 , Jürgen Grauvogel  6 , Marco Bissolo  6 , Waseem Masalha  6   7 , Christine Steiert  6 , Oliver Schnell  6   7 , Jürgen Beck  6 , Florian Ebel  8   9 , David Bervini  8 , Andreas Raabe  8 , Thomas Eibl  10 , Hans-Herbert Steiner  10 , Karl-Michael Schebesch  10 , Nathan A Shlobin  11   12 , Khizar R Nandoliya  11   12 , Mark W Youngblood  11 , James P Chandler  11 , Stephen T Magill  11 , Alexander Romagna  3   13 , Jens Lehmberg  13 , Manuel Fuetsch  14   15 , Julian Spears  14 , Arwin Rezai  3 , Barbara Ladisich  3   16 , Matthias Demetz  3   17 , Christoph J Griessenauer  3 , Mika Niemelä  4 , Miikka Korja  4
Affiliations
Multicenter Study

Frailty indices predict mortality, complications and functional improvements in supratentorial meningioma patients over 80 years of age

Christoph Schwartz et al. J Neurooncol. 2024 Oct.

Abstract

Purpose: To assess whether the Modified 5 (mFI-5) and 11 (mFI-11) Factor Frailty Indices associate with postoperative mortality, complications, and functional benefit in supratentorial meningioma patients aged over 80 years.

Methods: Baseline characteristics were collected from eight centers. Based on the patients' preoperative status and comorbidities, frailty was assessed by the mFI-5 and mFI-11. The collected scores were categorized as "robust (mFI=0)", "pre-frail (mFI=1)", "frail (mFI=2)", and "significantly frail (mFI≥3)". Outcome was assessed by the Karnofsky Performance Scale (KPS); functional benefit was defined as improved KPS score. Additionally, we evaluated the patients' functional independence (KPS≥70) after surgery.

Results: The study population consisted of 262 patients (median age 83 years) with a median preoperative KPS of 70 (range 20 to 100). The 90-day and 1-year mortality were 9.0% and 13.2%; we recorded surgery-associated complications in 111 (42.4%) patients. At last follow-up within the postoperative first year, 101 (38.5%) patients showed an improved KPS, and 183 (69.8%) either gained or maintained functional independence. "Severely frail" patients were at an increased risk of death at 90 days (OR 16.3 (CI95% 1.7-158.7)) and one year (OR 11.7 (CI95% 1.9-71.7)); nine (42.9%) of severely frail patients died within the first year after surgery. The "severely frail" cohort had increased odds of suffering from surgery-associated complications (OR 3.9 (CI 95%) 1.3-11.3)), but also had a high chance for postoperative functional improvements by KPS≥20 (OR 6.6 (CI95% 1.2-36.2)).

Conclusion: The mFI-5 and mFI-11 associate with postoperative mortality, complications, and functional benefit. Even though "severely frail" patients had the highest risk morbidity and mortality, they had the highest chance for functional improvement.

Keywords: Elderly; Functional outcome; Meningioma; Modified 5 (mFI-5) and 11 (mFI-11) Factor Frailty Indices; Mortality.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Patient frailty and outcome
See this image and copyright information in PMC

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