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The prevalence and impact of frailty in patients with symptomatic lumbar spinal stenosis

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Abstract

Purpose

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.

Methods

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.

Results

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.

Conclusions

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.

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Acknowledgement

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.

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Authors and Affiliations

  1. Spine Center and Department of Orthopedic Surgery, Seoul National University College of Medicine and Seoul National University Bundang Hospital, 166 Gumiro, Bundang-gu, Sungnam, 463-707, Republic of Korea

    Ho-Joong Kim, Jeong Hyun Lee & Jin S. Yeom

  2. Division of Sports Science, Korea Institute of Sports Science, 727 Hwarang-lo Nowon-gu, Seoul, 139-242, Republic of Korea

    Saejong Park & Soo-Hyun Park

  3. Department of Orthopaedic Surgery, Seoul National University College of Medicine and Seoul National University Hospital, 101 Daehangno, Jongno-gu, Seoul, 110-744, Republic of Korea

    Bong-Soon Chang & Choon-Ki Lee

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  1. Ho-Joong Kim
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Correspondence to Jin S. Yeom.

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Kim, HJ., Park, S., Park, SH. et al. The prevalence and impact of frailty in patients with symptomatic lumbar spinal stenosis. Eur Spine J 28, 46–54 (2019). https://doi.org/10.1007/s00586-018-5710-1

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  • DOI: https://doi.org/10.1007/s00586-018-5710-1

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