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

Christoph Schwartz; Moritz F Ueberschaer; Ilari Rautalin; Jürgen Grauvogel; Marco Bissolo; Waseem Masalha; Christine Steiert; Oliver Schnell; Jürgen Beck; Florian Ebel; David Bervini; Andreas Raabe; Thomas Eibl; Hans-Herbert Steiner; Karl-Michael Schebesch; Nathan A Shlobin; Khizar R Nandoliya; Mark W Youngblood; James P Chandler; Stephen T Magill; Alexander Romagna; Jens Lehmberg; Manuel Fuetsch; Julian Spears; Arwin Rezai; Barbara Ladisich; Matthias Demetz; Christoph J Griessenauer; Mika Niemelä; Miikka Korja

doi:10.1007/s11060-024-04780-6

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

Christoph Schwartz, Moritz F Ueberschaer, Ilari Rautalin, Jürgen Grauvogel, Marco Bissolo, Waseem Masalha, Christine Steiert, Oliver Schnell, Jürgen Beck, Florian Ebel, David Bervini, Andreas Raabe, Thomas Eibl, Hans-Herbert Steiner, Karl-Michael Schebesch, Nathan A Shlobin, Khizar R Nandoliya, Mark W Youngblood, James P Chandler, Stephen T MagillAlexander Romagna, Jens Lehmberg, Manuel Fuetsch, Julian Spears, Arwin Rezai, Barbara Ladisich, Matthias Demetz, Christoph J Griessenauer, Mika Niemelä, Miikka Korja

Division of Neurosurgery (University Hospital St. Pölten)

Research output: Journal article (peer-reviewed) › Journal article

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.

Original language	English
Pages (from-to)	89-100
Number of pages	12
Journal	Journal of Neuro-Oncology
Volume	170
Issue number	1
DOIs	https://doi.org/10.1007/s11060-024-04780-6
Publication status	Published - Oct 2024

Keywords

Humans
Female
Male
Aged, 80 and over
Frailty/mortality
Postoperative Complications/mortality
Meningioma/mortality
Meningeal Neoplasms/mortality
Supratentorial Neoplasms/surgery
Karnofsky Performance Status
Follow-Up Studies
Retrospective Studies
Prognosis
Frail Elderly

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Schwartz, C., Ueberschaer, M. F., Rautalin, I., Grauvogel, J., Bissolo, M., Masalha, W., Steiert, C., Schnell, O., Beck, J., Ebel, F., Bervini, D., Raabe, A., Eibl, T., Steiner, H.-H., Schebesch, K.-M., Shlobin, N. A., Nandoliya, K. R., Youngblood, M. W., Chandler, J. P., ... Korja, M. (2024). Frailty indices predict mortality, complications and functional improvements in supratentorial meningioma patients over 80 years of age. Journal of Neuro-Oncology, 170(1), 89-100. https://doi.org/10.1007/s11060-024-04780-6

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

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 = "Humans, Female, Male, Aged, 80 and over, Frailty/mortality, Postoperative Complications/mortality, Meningioma/mortality, Meningeal Neoplasms/mortality, Supratentorial Neoplasms/surgery, Karnofsky Performance Status, Follow-Up Studies, Retrospective Studies, Prognosis, Frail Elderly",

author = "Christoph Schwartz and Ueberschaer, {Moritz F} and Ilari Rautalin and J{\"u}rgen Grauvogel and Marco Bissolo and Waseem Masalha and Christine Steiert and Oliver Schnell and J{\"u}rgen Beck and Florian Ebel and David Bervini and Andreas Raabe and Thomas Eibl and Hans-Herbert Steiner and Karl-Michael Schebesch and Shlobin, {Nathan A} and Nandoliya, {Khizar R} and Youngblood, {Mark W} and Chandler, {James P} and Magill, {Stephen T} and Alexander Romagna and Jens Lehmberg and Manuel Fuetsch and Julian Spears and Arwin Rezai and Barbara Ladisich and Matthias Demetz and Griessenauer, {Christoph J} and Mika Niemel{\"a} and Miikka Korja",

note = "Publisher Copyright: {\textcopyright} The Author(s) 2024.",

year = "2024",

month = oct,

doi = "10.1007/s11060-024-04780-6",

language = "English",

volume = "170",

pages = "89--100",

journal = "Journal of Neuro-Oncology",

issn = "0167-594X",

publisher = "Springer",

number = "1",

}

Schwartz, C, Ueberschaer, MF, Rautalin, I, Grauvogel, J, Bissolo, M, Masalha, W, Steiert, C, Schnell, O, Beck, J, Ebel, F, Bervini, D, Raabe, A, Eibl, T, Steiner, H-H, Schebesch, K-M, Shlobin, NA, Nandoliya, KR, Youngblood, MW, Chandler, JP, Magill, ST, Romagna, A, Lehmberg, J, Fuetsch, M, Spears, J, Rezai, A, Ladisich, B, Demetz, M, Griessenauer, CJ, Niemelä, M & Korja, M 2024, 'Frailty indices predict mortality, complications and functional improvements in supratentorial meningioma patients over 80 years of age', Journal of Neuro-Oncology, vol. 170, no. 1, pp. 89-100. https://doi.org/10.1007/s11060-024-04780-6

TY - JOUR

T1 - Frailty indices predict mortality, complications and functional improvements in supratentorial meningioma patients over 80 years of age

AU - Schwartz, Christoph

AU - Ueberschaer, Moritz F

AU - Rautalin, Ilari

AU - Grauvogel, Jürgen

AU - Bissolo, Marco

AU - Masalha, Waseem

AU - Steiert, Christine

AU - Schnell, Oliver

AU - Beck, Jürgen

AU - Ebel, Florian

AU - Bervini, David

AU - Raabe, Andreas

AU - Eibl, Thomas

AU - Steiner, Hans-Herbert

AU - Schebesch, Karl-Michael

AU - Shlobin, Nathan A

AU - Nandoliya, Khizar R

AU - Youngblood, Mark W

AU - Chandler, James P

AU - Magill, Stephen T

AU - Romagna, Alexander

AU - Lehmberg, Jens

AU - Fuetsch, Manuel

AU - Spears, Julian

AU - Rezai, Arwin

AU - Ladisich, Barbara

AU - Demetz, Matthias

AU - Griessenauer, Christoph J

AU - Niemelä, Mika

AU - Korja, Miikka

N1 - Publisher Copyright: © The Author(s) 2024.

PY - 2024/10

Y1 - 2024/10

N2 - 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.

AB - 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.

KW - Humans

KW - Female

KW - Male

KW - Aged, 80 and over

KW - Frailty/mortality

KW - Postoperative Complications/mortality

KW - Meningioma/mortality

KW - Meningeal Neoplasms/mortality

KW - Supratentorial Neoplasms/surgery

KW - Karnofsky Performance Status

KW - Follow-Up Studies

KW - Retrospective Studies

KW - Prognosis

KW - Frail Elderly

UR - http://www.scopus.com/inward/record.url?scp=85203286088&partnerID=8YFLogxK

U2 - 10.1007/s11060-024-04780-6

DO - 10.1007/s11060-024-04780-6

M3 - Journal article

C2 - 39230803

SN - 0167-594X

VL - 170

SP - 89

EP - 100

JO - Journal of Neuro-Oncology

JF - Journal of Neuro-Oncology

IS - 1

ER -

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

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Keywords

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