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Influence of Frailty Status on the Efficacy of Epidural Steroid Injections in Elderly Patients With Degenerative Lumbar Spinal Disease.
Kim, Hee Jung; Nam, Ho Jae; Kim, Shin Hyung.
Afiliación
  • Kim HJ; Department of Anesthesiology and Pain Medicine Anesthesia and Pain Research Institute Yonsei University College of Medicine, Seoul, Republic of Korea.
  • Nam HJ; Department of Anesthesiology and Pain Medicine Anesthesia and Pain Research Institute Yonsei University College of Medicine, Seoul, Republic of Korea.
  • Kim SH; Department of Anesthesiology and Pain Medicine Anesthesia and Pain Research Institute Yonsei University College of Medicine, Seoul, Republic of Korea.
Pain Res Manag ; 2024: 5038496, 2024.
Article en En | MEDLINE | ID: mdl-39281846
ABSTRACT

Background:

The global increase in the elderly population has led to a higher prevalence of degenerative lumbar spinal diseases. Epidural steroid injection (ESI) is a widely used procedure for managing lower back pain. This study investigated the association of preprocedural frailty status with the efficacy of ESI in elderly patients diagnosed with degenerative lumbar spinal diseases.

Methods:

This retrospective observational study included patients aged 65 years and older who underwent lumbar ESI. Frailty status (robust, prefrail, and frail) assessed via the Frailty Phenotype Questionnaire was collected along with demographic and clinical parameters. Good analgesia was defined as a ≥ 50% reduction in pain score at 4-week follow-up evaluation. Multivariable logistic regression analyses were performed to identify factors associated with poor analgesia.

Results:

We included 289 patients in this study. Frailty status correlated with analgesic outcomes, with worsening frailty status correlating with increasingly poor analgesia after the injection (robust = 34.5%, prefrail = 40.8%, and frail = 60.0%, p=0.003), predominantly in female patients. After adjusting for demographic and clinical factors, frail patients demonstrated much higher odds of poor analgesia than robust individuals (adjusted odds ratio [aOR] = 2.673, 95% confidence interval [CI] = 1.338-5.342, p=0.005). Conversely, prefrail patients did not show a significant association with analgesic outcome (aOR = 1.293, 95% CI = 0.736-2.272, p=0.372).

Conclusions:

Frailty, but not prefrailty, appeared to be an independent factor associated with poor analgesic efficacy of ESI in elderly patients with symptomatic degenerative lumbar spinal disease receiving conservative care.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Fragilidad / Vértebras Lumbares Límite: Aged / Aged80 / Female / Humans / Male Idioma: En Revista: Pain Res Manag Asunto de la revista: NEUROLOGIA / PSICOFISIOLOGIA Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Fragilidad / Vértebras Lumbares Límite: Aged / Aged80 / Female / Humans / Male Idioma: En Revista: Pain Res Manag Asunto de la revista: NEUROLOGIA / PSICOFISIOLOGIA Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos