Frailty as an Independent predictor of perioperative risk and recovery in long-segment thoracolumbar fusion surgery: A retrospective cohort study

Frailty independently predicts longer anesthesia duration, greater EBL, increased intraoperative transfusion requirements, and significantly delayed postoperative recovery in ASD patients, including prolonged ICU stays, extended hospital LOS, and delayed ambulation. While targeted perioperative strategies-such as optimizing preoperative comorbidities and enhancing intraoperative monitoring and rehabilitation-may not reduce a patient's underlying frailty status, our findings suggest that early identification of frailty can help tailor perioperative planning, anticipate recovery trajectories, and support informed decision-making for clinicians and patients.