Use frailty as a predictor of postoperative outcomes in Parkinson’s Disease (PD) patients undergoing deep brain stimulation (DBS) using the Nationwide Inpatient Sample (NIS).

This retrospective cohort study analyzed NIS data from 2016-2020, identifying PD patients who received DBS. Frailty was determined using the 11-item mFI-11, with patients classified into frail and non-frail groups. Primary outcomes included prolonged length of stay (LOS) beyond the 75th percentile, non-routine discharge, and postoperative complications. Secondary outcomes involved total hospital costs. Univariate and multivariate analyses were performed, adjusting for demographics, comorbidities (CCI), and hospital characteristics.

A total of 3,545 patients met the inclusion criteria. Frailty was associated with significantly higher odds of unfavorable discharge (aOR: 1.80, 95% CI: 1.47–2.20, p < 0.001), prolonged LOS (aOR: 2.01, 95% CI: 1.59–2.57, p < 0.001), and postoperative complications (OR: 1.57, 95% CI: 1.45–1.70, p < 0.001). In the lower CCI group, frailty was significantly associated with both prolonged LOS (aOR: 1.63, 95% CI: 1.25–2.13) and non-routine discharge (aOR: 1.47, 95% CI: 1.18–1.84). Among patients with higher CCI scores, frail patients also had increased odds of unfavorable outcomes, though less pronounced. Frailty was linked to an additional $6,588 in hospital costs (p = 0.004).

Frailty is a strong predictor of adverse outcomes in PD patients undergoing DBS, including prolonged LOS, non-routine discharge, and postoperative complications. These findings suggest that incorporating frailty assessments into preoperative planning may improve outcomes and reduce healthcare costs.