# Impact of Frailty on Functional Improvement Following Traumatic Spinal Cord Injury: A Japanese Single-Center Experience

## TL;DR

Frailty before spinal cord injury is linked to worse recovery and lower chances of returning home.

## Contribution

This study shows that pre-injury frailty negatively affects functional recovery and discharge outcomes in SCI patients.

## Key findings

- Frail patients had 16.7% SCIM improvement vs. 33.5% in robust patients.
- Frailty was associated with a 45.8% home discharge rate compared to 68.0% for robust individuals.
- mFI scores showed a significant negative correlation with SCIM improvement (R = −0.231, p = 0.014).

## Abstract

Study Design: This is a retrospective case series study. Objective: The aim of this study was to investigate whether frailty contributes to functional recovery in individuals with spinal cord injury (SCI). Methods: A total of 121 patients with SCI (106 cervical SCI, 15 thoracic SCI) discharged from our center over the past three years were studied. Moreover, 11-factor modified frailty index (mFI) scores, the length of hospital stays, the rate of returning home, and improvement in Spinal Cord Independence Measure (SCIM) scores were assessed retrospectively. Results: The average age at the time of injury for all 121 cases was 59.6 years. Based on pre-injury assessments, 24 cases were categorized as the Frail group, and 97 cases were categorized as the Robust group. The Frail group had SCIM improvement rates of 16.7% and a home discharge rate of 45.8%. In contrast, the Robust group had SCIM improvement rates of 33.5% and a home discharge rate of 68.0%, with statistically significant differences between the two groups. A significant negative correlation was observed between mFI scores and SCIM improvement rates (R = −0.231, p = 0.014). Conclusions: This study suggests that individuals with pre-existing frailty before SCI experience poorer SCIM improvement rates and face challenges in returning home.