Abstract:

Objective

To systematically evaluate the relationship between frailty index （FI） and postoperative complications after lumbar spinal surgery.

Methods

This article retrieved relevant studies about the relationship between FI and postoperative complications after lumbar spinal surgery from PubMed，Cochrane Library， Web of Science， EMbase， CINAHL， CNKI， VIP database， Wanfang Medical Database and China Biomedical Literature Database.The retrieval time limit was from the establishment of the database to January 1， 2025.Two researchers independently conducted literature screening， quality evaluation， and data extraction.Stata 18.0 software was used for meta-analysis.

Results

A total of 14 articles were included.Meta-analysis results showed that frail patients had a higher risk of any postoperative complications after lumbar spinal surgery （OR=1.67，95% CI：1.38～2.01，P＜0.001）， death （OR=9.33，95%CI：1.41～61.71，P＜0.001）， pulmonary complications （OR=3.09，95%CI：2.36～4.05，P=0.341）， urinary complications （OR=1.74，95%CI：1.08～2.83，P=0.044），cardiac complications （OR=2.99，95%CI：2.36～3.80，P=0.941）， cardiovascular disease （OR=2.94，95%CI：2.12～4.07，P=0.983），sepsis （OR=1.92，95%CI：1.61～2.29，P=0.473），surgical site infections （OR=1.51，95%CI：1.29～1.76，P=0.741），postoperative transfusion （OR=1.36，95%CI：1.17～1.59，P=0.289）， readmission （OR=1.59，95%CI：1.23～2.06，P=0.284） and reoperation （OR=1.36，95%CI：1.07～1.73，P=0.294）， but there was no statistically significant association between preoperative frailty and postoperative gastrointestinal complications （OR=0.86，95%CI：0.55～1.37，P=0.396）， delirium （OR=1.33，95%CI：0.93～1.91，P=0.480） and deep vein thrombosis （OR=1.10，95%CI：0.89～1.36，P=0.915）.

Conclusion

Frail patients have a significantly higher risk of postoperative complications after lumbar surgery compared to non-frail patients.Medical and nursing staff should pay attention to the screening of patients' frailty and intervene as soon as possible to improve the prognosis of patients.

Key words: Lumbar vertebrae, Postoperative complications, Frailty index, Meta-analysis