{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T18:53:53Z","timestamp":1787165633581,"version":"build-2736575974"},"reference-count":30,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,7,22]],"date-time":"2025-07-22T00:00:00Z","timestamp":1753142400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,7,22]],"date-time":"2025-07-22T00:00:00Z","timestamp":1753142400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Acta Neurochir"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Meningioma resection constitutes a substantial portion of neurosurgical practice, with a variety of patient-factors playing a role in outcomes. This study aims to assess the role of frailty in elderly patients undergoing resection of primary intracranial meningiomas.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This is a retrospective study of patients undergoing resection for primary intracranial meningiomas at our institution between 2004\u20132024. Patients were\u2009\u2265\u200965\u00a0years, and were required to have\u2009\u2265\u20091\u00a0year of follow-up. The modified frailty index (mFI) was used to identify degree of frailty, categorising patients into the non-frail (NF, mFI\u2009=\u20090), pre-frail (PF, mFI\u2009=\u20091\/2), and frail (F, mFI\u2009\u2265\u20093) groups. The Shapiro\u2013Wilk test, paired T-test, and ANOVA were used to identify statistical significance. Propensity-score matching (PSM) was performed based on a multinomial logistic regression model and 1:1 nearest-neighbour matching algorithm. Kaplan\u2013Meier analysis using Log-rank tests were used to compare overall (OS) and progression-free (PFS) survival.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>362 patients were included, with 69, 207, and 86 patients in the NF, PF, and F groups respectively. Preoperatively, the F group was found to have a significantly higher age vs. the NF group (76.17 vs. 71.57, p\u2009=\u20090.0002), alongside reporting a significantly lower median KPS vs. the PF and NF groups (70 vs. 80, p\u2009&lt;\u20090.0001) respectively. The PF group was found to have a significantly lower duration of surgery (309\u00a0min, p\u2009=\u20090.0048) vs. the F group, which reported significantly higher mean length-of-stay (17.68\u00a0days, p\u2009&lt;\u20090.0001), higher frequencies of medical complications (11.6%, p\u2009=\u20090.0317), and lower postoperative KPS (70, p\u2009&lt;\u20090.0001) vs. other groups. Despite PSM, the F group was found to have significantly reduced median OS (p\u2009=\u20090.0106) and PFS (p\u2009=\u20090.0101) compared to other groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Frailty was significantly associated with higher length-of-stay, frequent medical complications, and worse OS and PFS following surgery vs. other groups. Frailty is hence a crucial consideration in preoperative planning for elderly populations undergoing meningioma resection.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00701-025-06616-2","type":"journal-article","created":{"date-parts":[[2025,7,22]],"date-time":"2025-07-22T05:57:36Z","timestamp":1753163856000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["The prognostic role of frailty on outcomes following meningioma resection in the elderly: a matched analysis employing baseline functional status"],"prefix":"10.1007","volume":"167","author":[{"given":"Yash","family":"Akkara","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Fernandes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ping Ping","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aron","family":"Abraham","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hamza","family":"Bhat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joe M.","family":"Das","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramesh","family":"Nair","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nigel","family":"Mendoza","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,7,22]]},"reference":[{"issue":"3","key":"6616_CR1","doi-asserted-by":"publisher","first-page":"380","DOI":"10.1093\/neuonc\/noy162","volume":"21","author":"RL Achey","year":"2018","unstructured":"Achey RL, Gittleman H, Schroer J, Khanna V, Kruchko C, Barnholtz-Sloan JS (2018) Nonmalignant and malignant meningioma incidence and survival in the elderly, 2005\u20132015, using the Central Brain Tumor Registry of the United States. 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Ethics approval has been granted, and is in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Human ethics declaration"}},{"value":"This is a retrospective study of patients treated at our institution. All patients consented to their data being used for retrospective data-analysis at our institution, with no directly identifiable patient data currently included within our study.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"This is a registered and approved audit of patients treated at our institution through resection of meningiomas, approved by the neurosurgical audit committee. 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