SUPC-05 FRAILTY AND SARCOPENIA IN SPINAL ONCOLOGY: A SYSTEMATIC REVIEW

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Abstract Introduction Metastatic spine disease (MSD) is increasingly common as new targeted therapies allow our patients to live to an elderly age, many with medical comorbidities. Frailty and sarcopenia are known predictors of worse surgical outcomes in degenerative and deformity-related populations, however, this relationship is less clear in the patients with MSD. We sought to review the literature detailing measurements of frailty and sarcopenia in the MSD population. Methods A systematic review of studies published from January 1, 2000 until June 2022 was performed. Among other study characteristics, frailty tools and measurements quantifying sarcopenia were collected. Clinimetric assessment was performed according to the Consensus-based Standards for Health Measurement Instruments. Results A total of 22 studies were included, consisting of over 45,000 patients. Seventeen (77%) of studies employed six frailty tools, the three most common of which were the Metastatic Spine Tumor Frailty Index (MSTFI), Modified Frailty Index-11 (mFI-11), and the mFI-5. The overall mean prevalence of frailty across cohorts was 69%, ranging from 21-100%, and the above tools were found to infrequently predict studied outcomes. Eight (36.4%) studies measured sarcopenia, most commonly the L3-Total Psoas Area (TPA) / Vertebral Body Area (VBA). The majority of sarcopenia measures also did not predict outcomes. No frailty tool received positive ratings for all clinimetric properties. Conclusion Frailty and sarcopenia are common in the MSD population and multidimensional measurements of health that must be carefully considered with regard to treatment decision making. However, this review reinforces the lack of readily available tool to quantify both conditions and their effect on outcomes. Standardization of tools that quantify these conditions will allow us to employ better surgical decision making and accurately measure the impact of frailty on clinical outcomes.

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