ArticleBrain & spine2026
The mFI-11 frailty index as a predictor of surgical outcomes in elderly patients with brain metastases.
Article in Brain & spine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: The vulnerability towards disease but also treatment in elderly patients has been referred to as frailty and can be measured using frailty indices, which assess functional health and comorbidities. Frailty has been shown to correlate with survival and functional outcomes in brain tumor patients. Research question: Does frailty, assessed by the 11-item modified Frailty Index (mFI-11), provide useful prognostic information in elderly patients undergoing brain metastasis surgery? Material and methods: A retrospective analysis of 139 patients aged ≥60 years who underwent brain metastasis resection (2015-2019) was conducted. Frailty was assessed using the mFI-11. Results: Increasing frailty correlated with poorer median overall survival (mFI 0: 13.8 months [95 %-CI: 8.7-18.9] vs. mFI 1-2l: 8.7 [5.8-11.6] vs. mFI≥3: 2.8 [0.9-4.6], p = 0.001) and functional outcome (postoperative KPS 80-100 %, mFI 0: 27/36 [75.0 %] vs. mFI 1-2: 44/64 [68.8 %] vs. mFI≥3: 13/38 [34.2 %], p < 0.001). Age was less prognostic. In the multivariate analyses, mFI-11 and age were not independently predictive, while KPS was. Frailty was not associated with major complications. Discussion: While frailty correlates with outcome, functional health rather than comorbidities and age is prognostic. The mFI-11's predictive ability may be largely due to its inclusion of a functional health assessment. Conclusion: Functional health (KPS) is a much stronger predictor of survival and functional outcome in the elderly than the presence of comorbidities and age, i.e. age per se and comorbidities without impact on the patient's functional health status (i.e. well-treated) should not deter from surgery. Frailty is not a predictor of complications.
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