Spinal cord · 2026
Predictive value of the 5-factor modified frailty index for pneumonia in older adults with cervical spinal cord injury.
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Saito Shinji, Ushiku Chikara, Ikegami Taku, Wakiya Hiroki, Kanai Tomoaki, Sawada Naomu, Saito Mitsuru
Аннотация
STUDY DESIGN: Retrospective cohort study.
OBJECTIVES: To examine whether frailty, assessed using the 5-factor modified frailty index (mFI-5), predicts pneumonia and other complications in older adults with cervical spinal cord injury (CSCI).
SETTING: A university-affiliated tertiary care hospital in Japan.
METHODS: Data from 94 adults aged ≥65 years who were treated for CSCI were retrospectively reviewed. Frailty was defined as mFI-5 score ≥2. Patients were classified into frail (mFI-5 ≥ 2) and non-frail (mFI-5 < 2) groups. Logistic regression analyses were performed to evaluate associations between frailty and the incidence of complications, infections, and pneumonia. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated. Model performance was assessed using receiver operating characteristic analysis.
RESULTS: Frailty was identified in 19% of patients. Overall, 45% of patients experienced complications, 37% developed infections, and 23% developed pneumonia. The frail group demonstrated significantly higher rates of complications, infections, and pneumonia compared with the non-frail group. In the multivariate analyses, frailty independently predicted pneumonia (OR: 6.8, 95% CI: 2.0-26) and infections (OR: 8.7, 95% CI: 2.1-45). Frailty, alongside high neurological injury level, was associated with an increased overall risk of complications. Predictive models demonstrated acceptable discriminatory ability for complications and infections.
CONCLUSIONS: Frailty, assessed using the mFI-5, is an independent predictor of pneumonia and infections in older adults with CSCI. Early assessment of frailty may facilitate perioperative risk stratification, targeted preventive strategies, and informed clinical decision-making in this high-risk population.
SPONSORSHIP: This work was supported by the Jikei University Research Fund.
OBJECTIVES: To examine whether frailty, assessed using the 5-factor modified frailty index (mFI-5), predicts pneumonia and other complications in older adults with cervical spinal cord injury (CSCI).
SETTING: A university-affiliated tertiary care hospital in Japan.
METHODS: Data from 94 adults aged ≥65 years who were treated for CSCI were retrospectively reviewed. Frailty was defined as mFI-5 score ≥2. Patients were classified into frail (mFI-5 ≥ 2) and non-frail (mFI-5 < 2) groups. Logistic regression analyses were performed to evaluate associations between frailty and the incidence of complications, infections, and pneumonia. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated. Model performance was assessed using receiver operating characteristic analysis.
RESULTS: Frailty was identified in 19% of patients. Overall, 45% of patients experienced complications, 37% developed infections, and 23% developed pneumonia. The frail group demonstrated significantly higher rates of complications, infections, and pneumonia compared with the non-frail group. In the multivariate analyses, frailty independently predicted pneumonia (OR: 6.8, 95% CI: 2.0-26) and infections (OR: 8.7, 95% CI: 2.1-45). Frailty, alongside high neurological injury level, was associated with an increased overall risk of complications. Predictive models demonstrated acceptable discriminatory ability for complications and infections.
CONCLUSIONS: Frailty, assessed using the mFI-5, is an independent predictor of pneumonia and infections in older adults with CSCI. Early assessment of frailty may facilitate perioperative risk stratification, targeted preventive strategies, and informed clinical decision-making in this high-risk population.
SPONSORSHIP: This work was supported by the Jikei University Research Fund.