{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T22:24:04Z","timestamp":1789424644284,"version":"build-2803163510"},"reference-count":45,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,2]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>Frailty, a state of decreased physiological reserve, has been shown to significantly impact outcomes of surgery. The authors sought to examine the impact of frailty on the short-term outcomes of patients undergoing transsphenoidal pituitary surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>Weighted data from the 2000\u20132014 National (Nationwide) Inpatient Sample were studied. Patients diagnosed with pituitary tumors or disorders who had undergone transsphenoidal pituitary surgery were identified. Frailty was determined using the Johns Hopkins Adjusted Clinical Groups (ACG) frailty-defining diagnoses indicator. Standard descriptive techniques and matched propensity score analyses were used to explore the odds ratios of postoperative complications, discharge dispositions, and costs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>A total of 115,317 cases were included in the analysis. Frailty was present in 1.48% of cases. The mean age of frail versus non-frail patients was 57.14 \u00b1 16.96 years (mean \u00b1 standard deviation) versus 51.91 \u00b1 15.88 years, respectively (p &lt; 0.001). A greater proportion of frail compared to non-frail patients had an age \u2265 65 years (37.08% vs 24.08%, respectively, p &lt; 0.001). Frail patients were more likely to be black or Hispanic (p &lt; 0.001), possess Medicare or Medicaid insurance (p &lt; 0.001), belong to lower-median-income groups (p &lt; 0.001), and have greater comorbidity (p &lt; 0.001). Results of propensity score\u2013matched multivariate analysis revealed that frail patients were more likely to develop fluid and electrolyte disorders (OR 1.61, 95% CI 1.07\u20132.43, p = 0.02), intracranial vascular complications (OR 2.73, 95% CI 1.01\u20137.49, p = 0.04), mental status changes (OR 3.60, 95% CI 1.65\u20137.82, p &lt; 0.001), and medical complications including pulmonary insufficiency (OR 2.01, 95% CI 1.13\u20134.05, p = 0.02) and acute kidney failure (OR 4.70, 95% CI 1.88\u201311.74, p = 0.01). The mortality rate was higher among frail patients (1.46% vs 0.37%, p &lt; 0.001). Frail patients also demonstrated a greater likelihood for nonroutine discharges (p &lt; 0.001), higher mean total charges ($109,614.33 [95% CI $92,756.09\u2013$126,472.50] vs $56,370.35 [95% CI $55,595.72\u2013$57,144.98], p &lt; 0.001), and longer hospitalizations (9.27 days [95% CI 7.79\u201310.75] vs 4.46 days [95% CI 4.39\u20134.53], p &lt; 0.001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Frailty in patients undergoing transsphenoidal pituitary surgery is associated with worse postoperative outcomes and higher costs, indicating that state\u2019s potential role in routine preoperative risk stratification.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2018.8.jns181875","type":"journal-article","created":{"date-parts":[[2019,2,26]],"date-time":"2019-02-26T19:16:02Z","timestamp":1551208562000},"page":"360-370","source":"Crossref","is-referenced-by-count":46,"title":["Impact of frailty on short-term outcomes in patients undergoing transsphenoidal pituitary surgery"],"prefix":"10.3171","volume":"132","author":[{"given":"Anthony O.","family":"Asemota","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gary L.","family":"Gallia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","series-title":"J Neurosurg Spine","doi-asserted-by":"publisher","first-page":"537","DOI":"10.3171\/2015.10.SPINE14582","article-title":"Use of the modified frailty index to predict 30-day morbidity and mortality from spine surgery","volume":"25","author":"Ali R","year":"2016","unstructured":"Ali R, Schwalb JM, Nerenz DR, Antoine HJ, Rubinfeld I: Use of the modified frailty index to predict 30-day morbidity and mortality from spine surgery. 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