PMC  PDF ISSUE 10(2)
Original Article
J Frailty Sarcopenia Falls 2025 Jun; 10(2):78-86 Copied!
10.22540/JFSF-10-078 Copied!

Shifts in Frailty in A Nationwide Cohort of Spinal Stenosis Patients in Germany During the COVID-19 Pandemic
  1. Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, Campus Bad Saarow, Bad Saarow, Germany
  2. Department of Neurosurgery, HELIOS Hospital Bad Saarow, Bad Saarow, Germany
  3. Fresenius SE & Co. KGaA, Bad Homburg, Germany
  4. Real World Evidence and Health Technology Assessment, Helios Health Institute, Berlin, Germany
  5. Department of Electrophysiology, Heart Center Leipzig, Germany


Abstract
Objectives
To examine shifts in frailty among spinal stenosis patients during the COVID-19 pandemic and associations with interventions and outcomes.
Methods
This retrospective analysis compared types of management and rates of in-hospital mortality between pre-pandemic (January 1, through December 31, 2019) and pandemic phases (March 5, 2020 through May 17, 2022) among spinal stenosis patients across a network of 76 hospitals in Germany, utilizing logistic generalized linear mixed models. Frailty was quantified using the Hospital Frailty Risk Score (HFRS) and categorized as low (<5 points), intermediate (5-15 points), and high (>15 points).
Results
Among the 59,130 patients with spinal stenosis, 39,448 were hospitalized during the pandemic, and 19,682 in 2019. During the pandemic, the proportion of patients with high frailty rose from 4.7%-5.5% to 6.2%-7.3% (p < 0.01), except in pandemic wave 5. Among low frailty patients, rates of decompressive surgery increased from 42.4%-46.0% to 48.4%-52.8% (p<0.001), and of fusion surgery from 15.7%-16.6% to 19.2%-22.8% (p<0.001). Throughout the pandemic, in-hospital mortality rates increased from 0.8%-1.0% to 1.0%-2.5% (p<0.017), yet without differences across frailty groups.
Conclusions
Among those hospitalized for spinal stenosis during the COVID-19 pandemic in Germany, frailty increased and low frailty was associated with rising rates of spine surgery.
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