ASSESSING PRE-OPERATIVE CARDIAC RISK IN ADULT SPINAL DEFORMITY SURGERY: CORRELATION BETWEEN MODIFIED FRAILTY SCORE AND REVISED CARDIAC RISK INDEX

Objective: Cardiac complications are one of the most important causes of death after major spinal surgery. This study aimed to evaluate the correlation between the 11-item and 5-item modified frailty index (mFI) and the revised cardiac risk index (RCRI) for predicting major adverse cardiac events (MACEs) after adult spinal deformity (ASD) corrective surgery. Materials and Methods: This retrospective study analyzed the records of 20 adult patients who underwent spine surgery for ASD between 2022-2023. The patients’ frailty and comorbidities were assessed using the mFI-5, mFI-11, and the American Society of Anesthesiologists Physical Status Classification System. RCRI was calculated to stratify the risk for predicting MACEs during hospitalization. The primary outcome was the presence of specific cardiac events within 30 days of surgery. Results: The study found that there was a significant positive correlation between RCRI and both mFI-5 and mFI-11 scores in terms of predicting MACEs. Three out of the 20 patients had MACEs postoperatively, and among them, one patient had an RCRI score of 1 but had a higher mFI score, indicating frailty. The other two patients had low RCRI scores but were considered prefrail according to the mFI scores. Conclusion: RCRI, mFI-5, and mFI-11 are correlated in terms of predicting cardiac risk after ASD surgery. Adding frailty scores to traditional risk estimation may provide additional prognostic information. However, this needs further investigation.