A New Risk Factor for Dysphagia After ACDF and Cervical Disc Replacement

What do you know about frailty?

What’s the Claim?

A retrospective study drawn from the institutional database of a high-volume spine center found that patients with markers of frailty were much more likely to develop dysphagia (odds ratio 4 [95% CI 1.2 to 13]) after controlling for relevant confounding variables. High (C3-4) surgery was also strongly associated (OR 12 [95% CI 1.4 to 109]). Higher T1 slope was associated with a slight increase in the odds of dysphagia. The most-useful finding here, of course, is the one linking frailty with dysphagia. And disturbingly, dysphagia persisted in 14% of patients who were accounted for 1 to 2 years after surgery.

“Frailty” is newer term that is seeing wider use, but it’s one that may not be familiar to all. It has been defined as:

. . . a clinically recognizable state of increased vulnerability resulting from aging-associated decline in reserve and function across multiple physiologic systems such that the ability to cope with everyday or acute stressors is comprised.

How’s It Stack Up?