{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T13:21:12Z","timestamp":1780060872888,"version":"3.54.0"},"reference-count":50,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,9,19]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>Cervical disc arthroplasty (CDA) is an emerging procedure aimed at addressing cervical disc degeneration while preserving motion at the affected spinal segment. This study examined how frailty, measured by the Hospital Frailty Risk Score (HFRS), affects in-hospital outcomes and readmissions post-CDA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>The authors conducted an analysis of the US Nationwide Readmissions Database (2016\u2013020) for adults undergoing CDA. Patients were categorized by HFRS into higher and lower risk groups. The study outcomes included in-hospital mortality, complications, and readmission rates at 30 and 90 days. Propensity score matching and logistic regression analyses were used to determine the associations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>After matching, data from 1017 patients (higher frailty risk: 339; lower frailty risk: 678) were analyzed, representing a total of 1726 individuals in the entire US after weighting. Compared with patients at lower risk, those at higher frailty risk had significantly higher risks of complications (OR 3.57, 95% CI 2.60\u20134.91). Specific complications included dysphagia (OR 3.79, 95% CI 2.41\u20135.96), infections (OR 2.56, 95% CI 1.55\u20134.24), urinary tract infections (OR 5.97, 95% CI 2.94\u201312.15), and cerebrovascular accidents (CVAs; OR 8.03, 95% CI 3.58\u201318.02) (all p &lt; 0.001). However, frailty did not significantly affect 30-day or 90-day readmission rates. The most frequent readmission diagnoses were spondylopathies (30-day: 17.2%; 90-day: 24.2%), followed by complications of other surgical or medical care, and septicemia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>This study shows that frailty, assessed by HFRS, significantly raises the risk of postoperative complications in patients undergoing CDA in US hospitals. These findings emphasize the need for preoperative evaluation of frailty for optimizing postsurgical care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2025.5.spine241632","type":"journal-article","created":{"date-parts":[[2025,11,17]],"date-time":"2025-11-17T20:52:12Z","timestamp":1763412732000},"page":"10-17","source":"Crossref","is-referenced-by-count":1,"title":["Hospital Frailty Risk Score and outcomes after cervical disc arthroplasty: analysis of US National Readmissions Database"],"prefix":"10.3171","volume":"44","author":[{"given":"Chien-Hua","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery, Wan Fang Hospital, Taipei Medical University, Taipei;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang-Hwei","family":"Tsuang","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Hsin Kuo Min Hospital, Taipei Medical University, Taoyuan; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi-Jie","family":"Kuo","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Wan Fang Hospital, Taipei Medical University, Taipei;"},{"name":"Department of Orthopedic Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"5","key":"b1","series-title":"Acta Neurochir (Wien)","first-page":"1105","article-title":"Degenerative cervical myelopathy: Where have we been? Where are we now? Where are we going?","volume":"165","author":"Hejrati N","year":"2023","unstructured":"Hejrati N, Pedro K, Alvi MA, Quddusi A, Fehlings MG. Degenerative cervical myelopathy: Where have we been? Where are we now? Where are we going? Acta Neurochir (Wien). 2023;165(5):1105\u20131119."},{"issue":"1","key":"b2","series-title":"J Neurosurg Spine","first-page":"42","article-title":"Cervical spondylotic myelopathy with severe axial neck pain: is anterior or posterior approach better?","volume":"38","author":"Chan AK","year":"2023","unstructured":"Chan AK, Shaffrey CI, Gottfried ON,  Cervical spondylotic myelopathy with severe axial neck pain: is anterior or posterior approach better? J Neurosurg Spine. 2023;38(1):42\u201355."},{"issue":"4","key":"b3","series-title":"J Spinal Cord Med","first-page":"1","article-title":"Cervical spondylotic myelopathy: a two decade experience","volume":"42","author":"Heary RF","year":"2018","unstructured":"Heary RF, MacDowall A, Agarwal N. Cervical spondylotic myelopathy: a two decade experience. J Spinal Cord Med. 2018;42(4):1\u20139."},{"issue":"2","key":"b4","series-title":"J Am Board Fam Med","first-page":"303","article-title":"Cervical spondylotic myelopathy: a guide to diagnosis and management","volume":"33","author":"McCormick JR","year":"2020","unstructured":"McCormick JR, Sama AJ, Schiller NC, Butler AJ, Donnally CJ III. Cervical spondylotic myelopathy: a guide to diagnosis and management. J Am Board Fam Med. 2020;33(2):303\u2013313."},{"issue":"1","key":"b5","series-title":"Clin Spine Surg","first-page":"E68","article-title":"Current management of cervical spondylotic myelopathy","volume":"35","author":"Donnally CJ","year":"2022","unstructured":"Donnally CJ, Patel PD, Canseco JA, Vaccaro AR, Kepler CK. Current management of cervical spondylotic myelopathy. Clin Spine Surg. 2022;35(1):E68\u2013E76."},{"issue":"1_suppl","key":"b6","series-title":"J Orthop Surg (Hong Kong)","first-page":"23094990211006934","article-title":"Cervical disc arthroplasty: what we know in 2020 and a literature review","volume":"29","author":"Shin JJ","year":"2021","unstructured":"Shin JJ, Kim KR, Son DW,  Cervical disc arthroplasty: what we know in 2020 and a literature review. J Orthop Surg (Hong Kong). 2021;29(1_suppl):23094990211006934."},{"issue":"3","key":"b7","series-title":"J Neurosurg Spine","first-page":"372","article-title":"Multilevel cervical disc arthroplasty: a review of optimal surgical management and future directions","volume":"38","author":"Tu TH","year":"2023","unstructured":"Tu TH, Wang CY, Chen YC, Wu JC. Multilevel cervical disc arthroplasty: a review of optimal surgical management and future directions. J Neurosurg Spine. 2023;38(3):372\u2013381."},{"issue":"1","key":"b8","series-title":"BMC Geriatr","first-page":"393","article-title":"A scoping review of the Clinical Frailty Scale","volume":"20","author":"Church S","year":"2020","unstructured":"Church S, Rogers E, Rockwood K, Theou O. A scoping review of the Clinical Frailty Scale. BMC Geriatr. 2020;20(1):393."},{"issue":"10206","key":"b9","series-title":"Lancet","first-page":"1365","article-title":"Frailty: implications for clinical practice and public health","volume":"394","author":"Hoogendijk EO","year":"2019","unstructured":"Hoogendijk EO, Afilalo J, Ensrud KE,  Frailty: implications for clinical practice and public health. Lancet. 2019;394(10206):1365\u20131375."},{"issue":"1","key":"b10","series-title":"Med Clin North Am","first-page":"183","article-title":"Frailty: a multidimensional biopsychosocial syndrome","volume":"107","author":"Cohen CI","year":"2023","unstructured":"Cohen CI, Benyaminov R, Rahman M, Ngu D, Reinhardt M. Frailty: a multidimensional biopsychosocial syndrome. Med Clin North Am. 2023;107(1):183\u2013197."},{"issue":"10132","key":"b11","series-title":"Lancet","first-page":"1775","article-title":"Development and validation of a Hospital Frailty Risk Score focusing on older people in acute care settings using electronic hospital records: an observational study","volume":"391","author":"Gilbert T","year":"2018","unstructured":"Gilbert T, Neuburger J, Kraindler J,  Development and validation of a Hospital Frailty Risk Score focusing on older people in acute care settings using electronic hospital records: an observational study. Lancet. 2018;391(10132):1775\u20131782."},{"issue":"2","key":"b12","series-title":"Age Ageing","first-page":"511","article-title":"The Hospital Frailty Risk Score-outcomes in specialised services","volume":"50","author":"Imam T","year":"2021","unstructured":"Imam T, Konstant-Hambling R, Fluck R,  The Hospital Frailty Risk Score-outcomes in specialised services. Age Ageing. 2021;50(2):511\u2013518."},{"key":"b13","series-title":"Arch Gerontol Geriatr","first-page":"104658","article-title":"Hospital Frailty Risk Score predicts outcomes in chronic obstructive pulmonary disease exacerbations","volume":"100","author":"Ushida K","year":"2022","unstructured":"Ushida K, Shimizu A, Hori S, Yamamoto Y, Momosaki R. Hospital Frailty Risk Score predicts outcomes in chronic obstructive pulmonary disease exacerbations. Arch Gerontol Geriatr. 2022;100:104658."},{"issue":"1","key":"b14","series-title":"Spine J","first-page":"124","article-title":"Leveraging HFRS to assess how frailty affects healthcare resource utilization after elective ACDF for CSM","volume":"23","author":"Elsamadicy AA","year":"2023","unstructured":"Elsamadicy AA, Koo AB, Sarkozy M,  Leveraging HFRS to assess how frailty affects healthcare resource utilization after elective ACDF for CSM. Spine J. 2023;23(1):124\u2013135."},{"issue":"12","key":"b15","series-title":"Am J Cancer Res","first-page":"5589","article-title":"The impact of frailty on breast cancer outcomes: evidence from analysis of the Nationwide Inpatient Sample","volume":"12","author":"Tsai HH","year":"2022","unstructured":"Tsai HH, Yu JC, Hsu HM,  The impact of frailty on breast cancer outcomes: evidence from analysis of the Nationwide Inpatient Sample. Am J Cancer Res. 2022;12(12):5589\u20135598."},{"issue":"2","key":"b16","series-title":"Int J Spine Surg","first-page":"230","article-title":"Cervical disc arthroplasty vs anterior cervical discectomy and fusion at 10 years: results from a prospective, randomized clinical trial at 3 sites","volume":"17","author":"Nunley PD","year":"2023","unstructured":"Nunley PD, Hisey M, Smith M, Stone MB. Cervical disc arthroplasty vs anterior cervical discectomy and fusion at 10 years: results from a prospective, randomized clinical trial at 3 sites. Int J Spine Surg. 2023;17(2):230\u2013240."},{"issue":"1","key":"b17","series-title":"J Spine Surg","first-page":"217","article-title":"Cervical disc arthroplasty versus anterior cervical discectomy and fusion: a meta-analysis of rates of adjacent-level surgery to 7-year follow-up","volume":"6","author":"Badhiwala JH","year":"2020","unstructured":"Badhiwala JH, Platt A, Witiw CD, Traynelis VC. Cervical disc arthroplasty versus anterior cervical discectomy and fusion: a meta-analysis of rates of adjacent-level surgery to 7-year follow-up. J Spine Surg. 2020;6(1):217\u2013232."},{"issue":"4","key":"b18","series-title":"Global Spine J","first-page":"525","article-title":"Spinal surgery in patients aged 80 years and older: risk stratification using the modified Frailty Index","volume":"11","author":"Kweh B","year":"2021","unstructured":"Kweh B, Lee H, Tan T,  Spinal surgery in patients aged 80 years and older: risk stratification using the modified Frailty Index. Global Spine J. 2021;11(4):525\u2013532."},{"issue":"2","key":"b19","series-title":"Aging Dis","first-page":"625","article-title":"The impact of frailty on spine surgery: systematic review on 10 years clinical studies","volume":"12","author":"Veronesi F","year":"2021","unstructured":"Veronesi F, Borsari V, Martini L,  The impact of frailty on spine surgery: systematic review on 10 years clinical studies. Aging Dis. 2021;12(2):625\u2013645."},{"issue":"2","key":"b20","series-title":"Spine (Phila Pa 1976)","first-page":"81","article-title":"Impact of frailty and cervical radiographic parameters on postoperative dysphagia following anterior cervical spine surgery","volume":"49","author":"Asada T","year":"2024","unstructured":"Asada T, Singh S, Maayan O,  Impact of frailty and cervical radiographic parameters on postoperative dysphagia following anterior cervical spine surgery. Spine (Phila Pa 1976). 2024;49(2):81\u201389."},{"issue":"7","key":"b21","series-title":"Eur Spine J","first-page":"1621","article-title":"Hospital frailty risk score predicts adverse events in spine surgery","volume":"31","author":"Pulido LC","year":"2022","unstructured":"Pulido LC, Meyer M, Reinhard J,  Hospital frailty risk score predicts adverse events in spine surgery. Eur Spine J. 2022;31(7):1621\u20131629."},{"key":"b22","series-title":"N Am Spine Soc J","first-page":"100318","article-title":"The 5-factor modified frailty index (mFI-5) predicts adverse outcomes after elective anterior cervical discectomy and fusion (ACDF)","volume":"18","author":"Chung MS","year":"2024","unstructured":"Chung MS, Patel N, Abdelmalek G,  The 5-factor modified frailty index (mFI-5) predicts adverse outcomes after elective anterior cervical discectomy and fusion (ACDF). N Am Spine Soc J. 2024;18:100318."},{"issue":"1","key":"b23","series-title":"J Clin Med","first-page":"114","article-title":"Impact of preoperative frailty on outcomes in patients with cervical spondylotic myelopathy undergoing anterior vs. posterior cervical surgery","volume":"13","author":"Elsamadicy AA","year":"2023","unstructured":"Elsamadicy AA, Sayeed S, Sherman JJZ,  Impact of preoperative frailty on outcomes in patients with cervical spondylotic myelopathy undergoing anterior vs. posterior cervical surgery. J Clin Med. 2023;13(1):114."},{"issue":"1","key":"b24","series-title":"PLoS One","first-page":"e0317234","article-title":"Using the Hospital Frailty Risk Score to predict length of stay across all adult ages","volume":"20","author":"Kutrani H","year":"2025","unstructured":"Kutrani H, Briggs J, Prytherch D, Spice C. Using the Hospital Frailty Risk Score to predict length of stay across all adult ages. PLoS One. 2025;20(1):e0317234."},{"issue":"7","key":"b25","series-title":"Dig Dis Sci","first-page":"2890","article-title":"Hospital Frailty Risk Score (HFRS) predicts adverse outcomes among hospitalized patients with chronic pancreatitis","volume":"68","author":"Kumar V","year":"2023","unstructured":"Kumar V, Barkoudah E, Jin DX, Banks P, McNabb-Baltar J. Hospital Frailty Risk Score (HFRS) predicts adverse outcomes among hospitalized patients with chronic pancreatitis. Dig Dis Sci. 2023;68(7):2890\u20132898."},{"issue":"5","key":"b1","series-title":"Acta Neurochir (Wien)","first-page":"1105","article-title":"Degenerative cervical myelopathy: Where have we been? Where are we now? Where are we going?","volume":"165","author":"Hejrati N","year":"2023","unstructured":"Hejrati N, Pedro K, Alvi MA, Quddusi A, Fehlings MG. Degenerative cervical myelopathy: Where have we been? Where are we now? Where are we going? Acta Neurochir (Wien). 2023;165(5):1105\u20131119."},{"issue":"1","key":"b2","series-title":"J Neurosurg Spine","first-page":"42","article-title":"Cervical spondylotic myelopathy with severe axial neck pain: is anterior or posterior approach better?","volume":"38","author":"Chan AK","year":"2023","unstructured":"Chan AK, Shaffrey CI, Gottfried ON,  Cervical spondylotic myelopathy with severe axial neck pain: is anterior or posterior approach better? J Neurosurg Spine. 2023;38(1):42\u201355."},{"issue":"4","key":"b3","series-title":"J Spinal Cord Med","first-page":"1","article-title":"Cervical spondylotic myelopathy: a two decade experience","volume":"42","author":"Heary RF","year":"2018","unstructured":"Heary RF, MacDowall A, Agarwal N. Cervical spondylotic myelopathy: a two decade experience. J Spinal Cord Med. 2018;42(4):1\u20139."},{"issue":"2","key":"b4","series-title":"J Am Board Fam Med","first-page":"303","article-title":"Cervical spondylotic myelopathy: a guide to diagnosis and management","volume":"33","author":"McCormick JR","year":"2020","unstructured":"McCormick JR, Sama AJ, Schiller NC, Butler AJ, Donnally CJ III. Cervical spondylotic myelopathy: a guide to diagnosis and management. J Am Board Fam Med. 2020;33(2):303\u2013313."},{"issue":"1","key":"b5","series-title":"Clin Spine Surg","first-page":"E68","article-title":"Current management of cervical spondylotic myelopathy","volume":"35","author":"Donnally CJ","year":"2022","unstructured":"Donnally CJ, Patel PD, Canseco JA, Vaccaro AR, Kepler CK. Current management of cervical spondylotic myelopathy. Clin Spine Surg. 2022;35(1):E68\u2013E76."},{"issue":"1_suppl","key":"b6","series-title":"J Orthop Surg (Hong Kong)","first-page":"23094990211006934","article-title":"Cervical disc arthroplasty: what we know in 2020 and a literature review","volume":"29","author":"Shin JJ","year":"2021","unstructured":"Shin JJ, Kim KR, Son DW,  Cervical disc arthroplasty: what we know in 2020 and a literature review. J Orthop Surg (Hong Kong). 2021;29(1_suppl):23094990211006934."},{"issue":"3","key":"b7","series-title":"J Neurosurg Spine","first-page":"372","article-title":"Multilevel cervical disc arthroplasty: a review of optimal surgical management and future directions","volume":"38","author":"Tu TH","year":"2023","unstructured":"Tu TH, Wang CY, Chen YC, Wu JC. Multilevel cervical disc arthroplasty: a review of optimal surgical management and future directions. J Neurosurg Spine. 2023;38(3):372\u2013381."},{"issue":"1","key":"b8","series-title":"BMC Geriatr","first-page":"393","article-title":"A scoping review of the Clinical Frailty Scale","volume":"20","author":"Church S","year":"2020","unstructured":"Church S, Rogers E, Rockwood K, Theou O. A scoping review of the Clinical Frailty Scale. BMC Geriatr. 2020;20(1):393."},{"issue":"10206","key":"b9","series-title":"Lancet","first-page":"1365","article-title":"Frailty: implications for clinical practice and public health","volume":"394","author":"Hoogendijk EO","year":"2019","unstructured":"Hoogendijk EO, Afilalo J, Ensrud KE,  Frailty: implications for clinical practice and public health. Lancet. 2019;394(10206):1365\u20131375."},{"issue":"1","key":"b10","series-title":"Med Clin North Am","first-page":"183","article-title":"Frailty: a multidimensional biopsychosocial syndrome","volume":"107","author":"Cohen CI","year":"2023","unstructured":"Cohen CI, Benyaminov R, Rahman M, Ngu D, Reinhardt M. Frailty: a multidimensional biopsychosocial syndrome. Med Clin North Am. 2023;107(1):183\u2013197."},{"issue":"10132","key":"b11","series-title":"Lancet","first-page":"1775","article-title":"Development and validation of a Hospital Frailty Risk Score focusing on older people in acute care settings using electronic hospital records: an observational study","volume":"391","author":"Gilbert T","year":"2018","unstructured":"Gilbert T, Neuburger J, Kraindler J,  Development and validation of a Hospital Frailty Risk Score focusing on older people in acute care settings using electronic hospital records: an observational study. Lancet. 2018;391(10132):1775\u20131782."},{"issue":"2","key":"b12","series-title":"Age Ageing","first-page":"511","article-title":"The Hospital Frailty Risk Score-outcomes in specialised services","volume":"50","author":"Imam T","year":"2021","unstructured":"Imam T, Konstant-Hambling R, Fluck R,  The Hospital Frailty Risk Score-outcomes in specialised services. Age Ageing. 2021;50(2):511\u2013518."},{"key":"b13","series-title":"Arch Gerontol Geriatr","first-page":"104658","article-title":"Hospital Frailty Risk Score predicts outcomes in chronic obstructive pulmonary disease exacerbations","volume":"100","author":"Ushida K","year":"2022","unstructured":"Ushida K, Shimizu A, Hori S, Yamamoto Y, Momosaki R. Hospital Frailty Risk Score predicts outcomes in chronic obstructive pulmonary disease exacerbations. Arch Gerontol Geriatr. 2022;100:104658."},{"issue":"1","key":"b14","series-title":"Spine J","first-page":"124","article-title":"Leveraging HFRS to assess how frailty affects healthcare resource utilization after elective ACDF for CSM","volume":"23","author":"Elsamadicy AA","year":"2023","unstructured":"Elsamadicy AA, Koo AB, Sarkozy M,  Leveraging HFRS to assess how frailty affects healthcare resource utilization after elective ACDF for CSM. Spine J. 2023;23(1):124\u2013135."},{"issue":"12","key":"b15","series-title":"Am J Cancer Res","first-page":"5589","article-title":"The impact of frailty on breast cancer outcomes: evidence from analysis of the Nationwide Inpatient Sample","volume":"12","author":"Tsai HH","year":"2022","unstructured":"Tsai HH, Yu JC, Hsu HM,  The impact of frailty on breast cancer outcomes: evidence from analysis of the Nationwide Inpatient Sample. Am J Cancer Res. 2022;12(12):5589\u20135598."},{"issue":"2","key":"b16","series-title":"Int J Spine Surg","first-page":"230","article-title":"Cervical disc arthroplasty vs anterior cervical discectomy and fusion at 10 years: results from a prospective, randomized clinical trial at 3 sites","volume":"17","author":"Nunley PD","year":"2023","unstructured":"Nunley PD, Hisey M, Smith M, Stone MB. Cervical disc arthroplasty vs anterior cervical discectomy and fusion at 10 years: results from a prospective, randomized clinical trial at 3 sites. Int J Spine Surg. 2023;17(2):230\u2013240."},{"issue":"1","key":"b17","series-title":"J Spine Surg","first-page":"217","article-title":"Cervical disc arthroplasty versus anterior cervical discectomy and fusion: a meta-analysis of rates of adjacent-level surgery to 7-year follow-up","volume":"6","author":"Badhiwala JH","year":"2020","unstructured":"Badhiwala JH, Platt A, Witiw CD, Traynelis VC. Cervical disc arthroplasty versus anterior cervical discectomy and fusion: a meta-analysis of rates of adjacent-level surgery to 7-year follow-up. J Spine Surg. 2020;6(1):217\u2013232."},{"issue":"4","key":"b18","series-title":"Global Spine J","first-page":"525","article-title":"Spinal surgery in patients aged 80 years and older: risk stratification using the modified Frailty Index","volume":"11","author":"Kweh B","year":"2021","unstructured":"Kweh B, Lee H, Tan T,  Spinal surgery in patients aged 80 years and older: risk stratification using the modified Frailty Index. Global Spine J. 2021;11(4):525\u2013532."},{"issue":"2","key":"b19","series-title":"Aging Dis","first-page":"625","article-title":"The impact of frailty on spine surgery: systematic review on 10 years clinical studies","volume":"12","author":"Veronesi F","year":"2021","unstructured":"Veronesi F, Borsari V, Martini L,  The impact of frailty on spine surgery: systematic review on 10 years clinical studies. Aging Dis. 2021;12(2):625\u2013645."},{"issue":"2","key":"b20","series-title":"Spine (Phila Pa 1976)","first-page":"81","article-title":"Impact of frailty and cervical radiographic parameters on postoperative dysphagia following anterior cervical spine surgery","volume":"49","author":"Asada T","year":"2024","unstructured":"Asada T, Singh S, Maayan O,  Impact of frailty and cervical radiographic parameters on postoperative dysphagia following anterior cervical spine surgery. Spine (Phila Pa 1976). 2024;49(2):81\u201389."},{"issue":"7","key":"b21","series-title":"Eur Spine J","first-page":"1621","article-title":"Hospital frailty risk score predicts adverse events in spine surgery","volume":"31","author":"Pulido LC","year":"2022","unstructured":"Pulido LC, Meyer M, Reinhard J,  Hospital frailty risk score predicts adverse events in spine surgery. Eur Spine J. 2022;31(7):1621\u20131629."},{"key":"b22","series-title":"N Am Spine Soc J","first-page":"100318","article-title":"The 5-factor modified frailty index (mFI-5) predicts adverse outcomes after elective anterior cervical discectomy and fusion (ACDF)","volume":"18","author":"Chung MS","year":"2024","unstructured":"Chung MS, Patel N, Abdelmalek G,  The 5-factor modified frailty index (mFI-5) predicts adverse outcomes after elective anterior cervical discectomy and fusion (ACDF). N Am Spine Soc J. 2024;18:100318."},{"issue":"1","key":"b23","series-title":"J Clin Med","first-page":"114","article-title":"Impact of preoperative frailty on outcomes in patients with cervical spondylotic myelopathy undergoing anterior vs. posterior cervical surgery","volume":"13","author":"Elsamadicy AA","year":"2023","unstructured":"Elsamadicy AA, Sayeed S, Sherman JJZ,  Impact of preoperative frailty on outcomes in patients with cervical spondylotic myelopathy undergoing anterior vs. posterior cervical surgery. J Clin Med. 2023;13(1):114."},{"issue":"1","key":"b24","series-title":"PLoS One","first-page":"e0317234","article-title":"Using the Hospital Frailty Risk Score to predict length of stay across all adult ages","volume":"20","author":"Kutrani H","year":"2025","unstructured":"Kutrani H, Briggs J, Prytherch D, Spice C. Using the Hospital Frailty Risk Score to predict length of stay across all adult ages. PLoS One. 2025;20(1):e0317234."},{"issue":"7","key":"b25","series-title":"Dig Dis Sci","first-page":"2890","article-title":"Hospital Frailty Risk Score (HFRS) predicts adverse outcomes among hospitalized patients with chronic pancreatitis","volume":"68","author":"Kumar V","year":"2023","unstructured":"Kumar V, Barkoudah E, Jin DX, Banks P, McNabb-Baltar J. Hospital Frailty Risk Score (HFRS) predicts adverse outcomes among hospitalized patients with chronic pancreatitis. 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