INTRODUCTION: Frailty is becoming increasingly prevalent in the elderly population although a lack of consensus regarding a clinical definition hampers comparison of clinical studies. More elderly patients are being assessed for surgical intervention but the effect of frailty on surgical related outcomes is still not clear. METHODS: A systematic literature search for studies prospectively reporting frailty and postoperative outcomes in patients undergoing surgical intervention was performed with data collated from a total of 12 studies. Random effects meta-analysis modelling was undertaken to estimate the association between frailty and mortality rates (in-hospital and one-year), length of hospital stay and the need for step-down care for further rehabilitation/nursing home placement. RESULTS: Frailty was associated with a higher in-hospital mortality rate (pooled odds ratio [OR]: 2.77, 95% confidence interval [CI]: 1.62-4.73), a higher one-year mortality rate (pooled OR: 1.99, 95% CI: 1.49-2.66), a longer hospital stay (pooled mean difference: 1.05 days, 95% CI: 0.02-2.07 days) and a higher discharge rate to further rehabilitation/step-down care (pooled OR: 5.71, 95% CI: 3.41-9.55). CONCLUSIONS: The presence of frailty in patients undergoing surgical intervention is associated with poorer outcomes with regard to mortality and return to independence. Further in-depth studies are required to identify factors that can be optimised to reduce the burden of frailty in surgical patients.
INTRODUCTION: Frailty is becoming increasingly prevalent in the elderly population although a lack of consensus regarding a clinical definition hampers comparison of clinical studies. More elderly patients are being assessed for surgical intervention but the effect of frailty on surgical related outcomes is still not clear. METHODS: A systematic literature search for studies prospectively reporting frailty and postoperative outcomes in patients undergoing surgical intervention was performed with data collated from a total of 12 studies. Random effects meta-analysis modelling was undertaken to estimate the association between frailty and mortality rates (in-hospital and one-year), length of hospital stay and the need for step-down care for further rehabilitation/nursing home placement. RESULTS: Frailty was associated with a higher in-hospital mortality rate (pooled odds ratio [OR]: 2.77, 95% confidence interval [CI]: 1.62-4.73), a higher one-year mortality rate (pooled OR: 1.99, 95% CI: 1.49-2.66), a longer hospital stay (pooled mean difference: 1.05 days, 95% CI: 0.02-2.07 days) and a higher discharge rate to further rehabilitation/step-down care (pooled OR: 5.71, 95% CI: 3.41-9.55). CONCLUSIONS: The presence of frailty in patients undergoing surgical intervention is associated with poorer outcomes with regard to mortality and return to independence. Further in-depth studies are required to identify factors that can be optimised to reduce the burden of frailty in surgical patients.
Authors: Howard Bergman; Luigi Ferrucci; Jack Guralnik; David B Hogan; Silvia Hummel; Sathya Karunananthan; Christina Wolfson Journal: J Gerontol A Biol Sci Med Sci Date: 2007-07 Impact factor: 6.053
Authors: Roberto Cervera; Faisal G Bakaeen; Lorraine D Cornwell; Xing Li Wang; Joseph S Coselli; Scott A LeMaire; Danny Chu Journal: Ann Thorac Surg Date: 2012-05-03 Impact factor: 4.330
Authors: Jonathan Afilalo; Mark J Eisenberg; Jean-François Morin; Howard Bergman; Johanne Monette; Nicolas Noiseux; Louis P Perrault; Karen P Alexander; Yves Langlois; Nandini Dendukuri; Patrick Chamoun; Georges Kasparian; Sophie Robichaud; S Michael Gharacholou; Jean-François Boivin Journal: J Am Coll Cardiol Date: 2010-11-09 Impact factor: 24.094
Authors: L P Fried; C M Tangen; J Walston; A B Newman; C Hirsch; J Gottdiener; T Seeman; R Tracy; W J Kop; G Burke; M A McBurnie Journal: J Gerontol A Biol Sci Med Sci Date: 2001-03 Impact factor: 6.053
Authors: Rita Rastogi Kalyani; Ravi Varadhan; Carlos O Weiss; Linda P Fried; Anne R Cappola Journal: J Gerontol A Biol Sci Med Sci Date: 2011-08-26 Impact factor: 6.053
Authors: Jay Soong-Jin Lee; Kevin He; Calista M Harbaugh; Douglas E Schaubel; Christopher J Sonnenday; Stewart C Wang; Michael J Englesbe; Jonathan L Eliason Journal: J Vasc Surg Date: 2011-01-07 Impact factor: 4.268
Authors: Gabor Abellan van Kan; Yves Rolland; Mathieu Houles; Sophie Gillette-Guyonnet; Maria Soto; Bruno Vellas Journal: Clin Geriatr Med Date: 2010-05 Impact factor: 3.076
Authors: Alfonso J Cruz-Jentoft; Jean Pierre Baeyens; Jürgen M Bauer; Yves Boirie; Tommy Cederholm; Francesco Landi; Finbarr C Martin; Jean-Pierre Michel; Yves Rolland; Stéphane M Schneider; Eva Topinková; Maurits Vandewoude; Mauro Zamboni Journal: Age Ageing Date: 2010-04-13 Impact factor: 10.668
Authors: Simon J G Richards; Frank A Frizelle; John A Geddes; Tim W Eglinton; Mark B Hampton Journal: Int J Colorectal Dis Date: 2018-09-14 Impact factor: 2.571
Authors: Leon Lenchik; Ryan Barnard; Robert D Boutin; Stephen B Kritchevsky; Haiying Chen; Josh Tan; Peggy M Cawthon; Ashley A Weaver; Fang-Chi Hsu Journal: J Gerontol A Biol Sci Med Sci Date: 2021-01-18 Impact factor: 6.053
Authors: Leon Lenchik; Kristin M Lenoir; Josh Tan; Robert D Boutin; Kathryn E Callahan; Stephen B Kritchevsky; Brian J Wells Journal: J Gerontol A Biol Sci Med Sci Date: 2019-06-18 Impact factor: 6.053
Authors: Elizabeth M Morgan; Johanna C Heseltine; Gwendolyn J Levine; Daniel E L Promislow; Kate E Creevy Journal: Am J Vet Res Date: 2019-07 Impact factor: 1.156
Authors: Patricia Torres-Perez; María Álvarez-Satta; Mariano Arrazola; Larraitz Egaña; Manuel Moreno-Valladares; Jorge Villanua; Irune Ruiz; Nicolas Sampron; Ander Matheu Journal: Am J Cancer Res Date: 2021-06-15 Impact factor: 6.166