The prevalence and impact of frailty in patients with symptomatic lumbar spinal stenosis
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To investigate the prevalence of frailty in patients with symptomatic lumbar spinal stenosis (LSS) and a propensity score-matched control group, and to analyze the association between symptomatic LSS and frailty.
This study included 2 groups: 1 consisting of patients with symptomatic LSS (LSS group) and the other including healthy elderly subjects without degenerative spinal disease (control group). Baseline sociodemographic data, variables regarding frailty assessment, and clinical outcomes were collected. The frailty was assessed with Fried criteria. Between the LSS and control groups, the prevalence of frailty was compared. Among all participants, risk factors for frailty were identified using multivariate logistic regression.
Totally, 843 subjects participated (142 in LSS group and 701 in control group) in this study. After the propensity score matching (142 in each group), the LSS group had significantly higher prevalence of frail than the control group (P < 0.001): 59 (41.5%) participants in the LSS group were frail, whereas 10 (7.0%) participants in the control group were frail. Within LSS group analysis showed that participants with frailty had significantly higher disability and lower quality of life compared to those in a robust state. Among all participants, LSS and age were found to be significant risk factors for frail in multivariate logistic regression model.
The present study highlights a strong association between symptomatic LSS and frailty. Furthermore, symptom severity and disability caused by LSS are significantly related to frailty. Therefore, early detection and appropriate treatment for frailty in patients with LSS is important.
KeywordsFrailty Lumbar spinal stenosis Fried frailty criteria Propensity score matching
Ho-Joong Kim, MD, and Saejong Park, PhD, contributed equally to the writing of this article. This study was supported by research grants from the Korea Sports Promotion Foundation and Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education, Science and Technology (2016R1A2B3012850). The funder had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
- 2.Cooper Z, Rogers SO Jr, Ngo L, Guess J, Schmitt E, Jones RN, Ayres DK, Walston JD, Gill TM, Gleason LJ, Inouye SK, Marcantonio ER (2016) Comparison of frailty measures as predictors of outcomes after orthopedic surgery. J Am Geriatr Soc 64(12):2464–2471. https://doi.org/10.1111/jgs.14387 CrossRefGoogle Scholar
- 9.Watters WC 3rd, Baisden J, Gilbert TJ, Kreiner S, Resnick DK, Bono CM, Ghiselli G, Heggeness MH, Mazanec DJ, O’Neill C, Reitman CA, Shaffer WO, Summers JT, Toton JF, North American Spine S (2008) Degenerative lumbar spinal stenosis: an evidence-based clinical guideline for the diagnosis and treatment of degenerative lumbar spinal stenosis. Spine J 8(2):305–310. https://doi.org/10.1016/j.spinee.2007.10.033 CrossRefGoogle Scholar
- 17.Hoogendijk EO, van Hout HP, Heymans MW, van der Horst HE, Frijters DH, Broese van Groenou MI, Deeg DJ, Huisman M (2014) Explaining the association between educational level and frailty in older adults: results from a 13-year longitudinal study in the Netherlands. Ann Epidemiol 24(7):538–544. https://doi.org/10.1016/j.annepidem.2014.05.002 CrossRefGoogle Scholar
- 20.Chang YW, Chen WL, Lin FG, Fang WH, Yen MY, Hsieh CC, Kao TW (2012) Frailty and its impact on health-related quality of life: a cross-sectional study on elder community-dwelling preventive health service users. PLoS One 7(5):e38079. https://doi.org/10.1371/journal.pone.0038079 CrossRefGoogle Scholar
- 22.Castell MV, van der Pas S, Otero A, Siviero P, Dennison E, Denkinger M, Pedersen N, Sanchez-Martinez M, Queipo R, van Schoor N, Zambon S, Edwards M, Peter R, Schaap L, Deeg D (2015) Osteoarthritis and frailty in elderly individuals across six European countries: results from the European Project on OSteoArthritis (EPOSA). BMC Musculoskelet Disord 16:359. https://doi.org/10.1186/s12891-015-0807-8 CrossRefGoogle Scholar
- 24.Tom SE, Adachi JD, Anderson FA Jr, Boonen S, Chapurlat RD, Compston JE, Cooper C, Gehlbach SH, Greenspan SL, Hooven FH, Nieves JW, Pfeilschifter J, Roux C, Silverman S, Wyman A, LaCroix AZ (2013) Frailty and fracture, disability, and falls: a multiple country study from the global longitudinal study of osteoporosis in women. J Am Geriatr Soc 61(3):327–334. https://doi.org/10.1111/jgs.12146 CrossRefGoogle Scholar