{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T01:02:45Z","timestamp":1780448565743,"version":"3.54.1"},"reference-count":114,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,6,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>Frailty is a known predictor of adverse outcomes in pituitary surgery, yet its impact regarding craniopharyngioma remains unclear. The authors assessed preoperative frailty, measured by the 11-factor modified frailty index (mFI-11), and its association with perioperative morbidity among adult patients undergoing craniopharyngioma surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>Using the Registry for Adenomas of the Pituitary and Related Disorders (RAPID) database, the authors performed a retrospective cohort study of the records of patients \u2265 18 years of age who underwent craniopharyngioma surgery between June 2007 and November 2024. Patients were stratified into the following categories according to their numeric mFI-11 score: fit (scores 0 and 1), managing well (scores 2 and 3), and mildly frail (scores 4\u20136). Primary outcomes included hospital length of stay (LOS) and discharge disposition. Secondary outcomes included 90-day readmission, surgical outcomes, and complications. Multivariable analyses were performed to identify independent predictors of hospital LOS and non-home discharge, adjusting for age, surgeon experience, American Society of Anesthesiologists class, complications, and surgical approach.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Among 278 patients (221 fit, 43 managing well, 14 mildly frail), higher-frailty patients were older (mean age 47.8 \u00b1 16.1 years in fit vs 60.1 \u00b1 12.5 years in managing well vs 67.6 \u00b1 8 years in mildly frail, p &lt; 0.001) and more likely to present urgently (24.2% vs 36.4% vs 78.6%, p = 0.001). Gross-total resection was achieved less frequently in frail patients (44.8% vs 24.3% vs 23.1%, p = 0.030). Overall complication rates were similar; however, increasing frailty was associated with higher rates of postoperative mortality (0% vs 2.8% [1\/36] vs 7.7% [1\/13], p = 0.018), pneumonia (0.5% [1\/195] vs 2.8% [1\/36] vs 15.4% [2\/13], p = 0.006), and reintubation (2.6% [5\/195] vs 2.8% [1\/36] vs 30.8% [4\/13], p = 0.002). Higher frailty was associated with a stepwise rise in median [IQR] LOS (5 [3\u20138] days vs 7 [4\u201312] days vs 13 [6.5\u201321.8] days, p &lt; 0.001) and remained an independent predictor of extended LOS on multivariable analysis (\u03b2 = 1.729 per point, p = 0.006). Rates of non-home discharge showed a similar pattern (9.2% vs 30.0% vs 64.3%, p &lt; 0.001), with frailty independently predicting non-home discharge (OR 2.352, 95% CI 1.527\u20133.822). Unplanned 90-day readmission rates were significantly higher in the mildly frail cohorts (22.5% vs 45.7% vs 53.8%, p = 0.002).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>The mFI-11 scores independently predicted perioperative morbidity following craniopharyngioma resection. Incorporating frailty screening into preoperative screening may improve risk stratification, family and patient counseling, and discharge planning.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2026.2.focus251160","type":"journal-article","created":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T00:00:57Z","timestamp":1779840057000},"page":"E7","source":"Crossref","is-referenced-by-count":0,"title":["Frailty and postoperative outcomes following craniopharyngioma resection: a multicenter Registry for Adenomas of the Pituitary and Related Disorders analysis"],"prefix":"10.3171","volume":"60","author":[{"given":"Sean T.","family":"Kelleher","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Thomas Jefferson University, Philadelphia, Pennsylvania;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony Yulin","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Thomas Jefferson University, Philadelphia, Pennsylvania;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rui","family":"Feng","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Thomas Jefferson University, Philadelphia, Pennsylvania;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Calen","family":"Collopy","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Thomas Jefferson University, Philadelphia, Pennsylvania;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert C.","family":"Rennert","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William T.","family":"Couldwell","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Varun R.","family":"Kshettry","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Cleveland Clinic Foundation, Cleveland, Ohio;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Gardner","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Pittsburgh Medical Center Health System, Pittsburgh, Pennsylvania;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie M.","family":"Silverstein","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, WashU Medicine, St. Louis;"},{"name":"Division of Endocrinology, Metabolism, and Lipid Research, WashU Medicine, St. Louis, Missouri;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Albert H.","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, WashU Medicine, St. Louis;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Garni","family":"Barkhoudarian","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Pacific Neuroscience Institute, Los Angeles, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Kelly","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Pacific Neuroscience Institute, Los Angeles, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donato R.","family":"Pacione","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, New York University Langone Medical Center, New York, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carter M.","family":"Suryadevara","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, New York University Langone Medical Center, New York, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Won","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of California, Los Angeles, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marvin","family":"Bergsneider","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of California, Los Angeles, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael R.","family":"Chicoine","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Missouri, Columbia, Missouri;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriel","family":"Zada","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Southern California, Los Angeles, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyle C.","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, The Ohio State University, Columbus, Ohio;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel M.","family":"Prevedello","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, The Ohio State University, Columbus, Ohio;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolina","family":"Benjamin","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Miami Miller School of Medicine, Miami, Florida;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael P.","family":"Catalino","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Virginia, Charlottesville;"},{"name":"Division of Endocrinology and Metabolism, University of Virginia, Charlottesville, Virginia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam","family":"Mamelak","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie K.","family":"Cheok","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathan T.","family":"Zwagerman","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jamie J.","family":"Van Gompel","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Mayo Clinic, Rochester, Minnesota;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandhya R.","family":"Palit","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Mayo Clinic, Rochester, Minnesota;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan C.","family":"Fernandez-Miranda","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Stanford University, Palo Alto, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin C. J.","family":"Yuen","sequence":"additional","affiliation":[{"name":"Department of Neuroendocrinology and Neurology, Barrow Neurological Institute, St. Joseph\u2019s Hospital and Medical Center, Phoenix;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew S.","family":"Little","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Barrow Neurological Institute, St. Joseph\u2019s Hospital and Medical Center, Phoenix, Arizona; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Karsy","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James J.","family":"Evans","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Thomas Jefferson University, Philadelphia, Pennsylvania;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"6","key":"b1","series-title":"N Engl J Med","first-page":"538","article-title":"Frailty in older adults","volume":"391","author":"Kim DH","year":"2024","unstructured":"Kim DH, Rockwood K. 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