Association of Frailty with Improvement of Daily Activities and Health-related Quality of Life in Patients with Lumbar Spinal Stenosis Following Decompression Surgery.

Abstract

This retrospective study aimed to investigate the association of frailty on postoperative activities of daily living (ADL) and health-related quality of life (QOL) in patients with lumbar spinal stenosis (LSS) and determine factors associated with low physical activity at 1 year postoperatively. One hundred sixty-two patients who underwent decompressive surgery for LSS were divided into frailty and non-frailty groups using the Edmonton frailty scale (EFS). The Frenchay activities index (FAI) as an ADL measure, and health-related QOL were compared between two groups, and predictors of postoperative low activity were analyzed. Sixty patients (37%) were diagnosed with frailty. LSS patients achieved significant clinical recovery on health-related QOL scores, regardless of frailty; however, FAI scores were lower in the frailty group at 1 year (P<0.001), particularly for outdoor activities and social participation. Frailty (odds ratio [OR], 2.532; P=0.008) and older age (OR, 1.323; P=0.024) were independently associated with reduced physical activities. Elderly LSS patients with frailty benefit from decompressive surgery in terms of QOL but remain at risk of reduced instrumental ADL, especially in social activities. Frailty assessment may provide a feasible strategy for initiating support to improve social engagement and for establishing individualized physical activity goals.