ArticleSpinal cord2026
Predictive value of the 5-factor modified frailty index for pneumonia in older adults with cervical spinal cord injury.
Article in Spinal cord, 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
STUDY
designRetrospective cohort study.
objectivesTo examine whether frailty, assessed using the 5-factor modified frailty index (mFI-5), predicts pneumonia and other complications in older adults with cervical spinal cord injury (CSCI).
settingA university-affiliated tertiary care hospital in Japan.
methodsData from 94 adults aged ≥65 years who were treated for CSCI were retrospectively reviewed. Frailty was defined as mFI-5 score ≥2. Patients were classified into frail (mFI-5 ≥ 2) and non-frail (mFI-5 < 2) groups. Logistic regression analyses were performed to evaluate associations between frailty and the incidence of complications, infections, and pneumonia. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated. Model performance was assessed using receiver operating characteristic analysis.
resultsFrailty was identified in 19% of patients. Overall, 45% of patients experienced complications, 37% developed infections, and 23% developed pneumonia. The frail group demonstrated significantly higher rates of complications, infections, and pneumonia compared with the non-frail group. In the multivariate analyses, frailty independently predicted pneumonia (OR: 6.8, 95% CI: 2.0-26) and infections (OR: 8.7, 95% CI: 2.1-45). Frailty, alongside high neurological injury level, was associated with an increased overall risk of complications. Predictive models demonstrated acceptable discriminatory ability for complications and infections.
conclusionsFrailty, assessed using the mFI-5, is an independent predictor of pneumonia and infections in older adults with CSCI. Early assessment of frailty may facilitate perioperative risk stratification, targeted preventive strategies, and informed clinical decision-making in this high-risk population. SPONSORSHIP: This work was supported by the Jikei University Research Fund.
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