Adverse Impact of Frailty on Postoperative Outcomes of Cervical Laminoplasty

Background: Although prior studies have examined the impact of frailty on surgeries for degenerative cervical conditions, these studies often involved heterogeneous sample populations in terms of surgical approaches. This study aimed to examine the impact of frailty and its severity on postoperative outcomes after cervical laminoplasty. Methods: This study examined the 2007–2022 ACS-NSQIP database. Patients who received cervical laminoplasty were queried and grouped according to the modified Frailty Index into nonfrail, prefrail, frail, and severely frail categories. The primary outcome was the occurrence of at least one complication within 30 days (excluding blood transfusions). Secondary outcomes were major and minor complication rates, readmission rates, and the length of hospital stay. Results: A total of 2250 patients were included, categorized as 829 nonfrail, 873 prefrail, 474 frail, and 74 severely frail patients. After controlling for confounders, frailty (odds ratio [OR] 1.661, 95% confidence interval [CI] 1.122–2.463; P = 0.011) and severe frailty (OR 4.328, 95% CI 2.271–8.253; P < 0.001) were independently associated with prolonged hospitalization. Additionally, severe frailty was independently correlated with a heightened risk of readmission (OR 3.976, 95% CI 1.392–10.959; P = 0.008), increased overall complication rates (OR 2.831, 95% CI 1.282–6.12; P = 0.009), and a higher likelihood of experiencing at least one major complication (OR 4.879, 95% CI 1.947–12.229; P = 0.001). Conclusions: Frailty and its severity may be associated with a higher rate of unfavorable perioperative outcomes after cervical laminoplasty. As a result, including frailty assessment in the preoperative evaluation of patients undergoing cervical laminoplasty could be beneficial for stratifying related risks.