Jacqueline Y Kikuchi1, Katerina Hoyt2, Andrea I Nomura3, Sindhura Vallabhaneni4, Jaime Blanck5, Danielle Patterson2, Chi Chiung Grace Chen2. 1. Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, 4940 Eastern Ave, 301 Building, Suite 3200, Baltimore, MD, 21224, USA. Jacqueline.kikuchi@gmail.com. 2. Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, 4940 Eastern Ave, 301 Building, Suite 3200, Baltimore, MD, 21224, USA. 3. Universidad Peruana Cayetano Heredia, Lima, Peru. 4. College of Medicine, Northeast Ohio Medical University, Rootstown, OH, USA. 5. Welch Medical Library, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Abstract
INTRODUCTION AND HYPOTHESIS: Frailty has been associated with increased risks of perioperative complications. This systematic review explores the associations between preoperative frailty and perioperative complications in benign gynecologic surgery. METHODS: A comprehensive, systematic literature search was conducted using the PubMed interface for Medline, Embase, and Scopus databases through August 12, 2020. Articles were included if they described the utilization of frailty assessment tools in benign gynecologic patients in the pre- or perioperative setting. Study quality and evidence were evaluated by the Cochrane Risk of Bias Tool in Non-Randomized Studies and Grading of Recommendations, Assessments, Development, and Evaluations criteria. RESULTS: One thousand one hundred twenty unique citations were identified, and five studies assessing frailty and perioperative outcomes were included. Three retrospective cohort studies utilized the American College of Surgeons National Surgical Quality Improvement Program database to assess the impact of frailty on perioperative outcomes in hysterectomies and pelvic organ prolapse repair procedures. One retrospective cohort study utilized a California database to assess frailty in prolapse repair surgeries. One cross-sectional study assessed frailty in new urogynecology patient visits. Four of these studies found that preoperative frailty is associated with an increased risk of perioperative complications. Overall, the evidence from the included studies is of low quality and at moderate to critical risk of bias. CONCLUSIONS: There are few studies assessing the impact of frailty on perioperative complications in benign gynecologic surgery. This review demonstrates that preoperative frailty is significantly associated with adverse perioperative outcomes, but additional studies are needed to further explore this association.
INTRODUCTION AND HYPOTHESIS: Frailty has been associated with increased risks of perioperative complications. This systematic review explores the associations between preoperative frailty and perioperative complications in benign gynecologic surgery. METHODS: A comprehensive, systematic literature search was conducted using the PubMed interface for Medline, Embase, and Scopus databases through August 12, 2020. Articles were included if they described the utilization of frailty assessment tools in benign gynecologic patients in the pre- or perioperative setting. Study quality and evidence were evaluated by the Cochrane Risk of Bias Tool in Non-Randomized Studies and Grading of Recommendations, Assessments, Development, and Evaluations criteria. RESULTS: One thousand one hundred twenty unique citations were identified, and five studies assessing frailty and perioperative outcomes were included. Three retrospective cohort studies utilized the American College of Surgeons National Surgical Quality Improvement Program database to assess the impact of frailty on perioperative outcomes in hysterectomies and pelvic organ prolapse repair procedures. One retrospective cohort study utilized a California database to assess frailty in prolapse repair surgeries. One cross-sectional study assessed frailty in new urogynecology patient visits. Four of these studies found that preoperative frailty is associated with an increased risk of perioperative complications. Overall, the evidence from the included studies is of low quality and at moderate to critical risk of bias. CONCLUSIONS: There are few studies assessing the impact of frailty on perioperative complications in benign gynecologic surgery. This review demonstrates that preoperative frailty is significantly associated with adverse perioperative outcomes, but additional studies are needed to further explore this association.
Authors: Anne M Suskind; Chengshi Jin; Matthew R Cooperberg; Emily Finlayson; W John Boscardin; Saunak Sen; Louise C Walter Journal: Urology Date: 2016-07-05 Impact factor: 2.649
Authors: Siri R Kristjansson; Arild Nesbakken; Marit S Jordhøy; Eva Skovlund; Riccardo A Audisio; Hans-Olaf Johannessen; Arne Bakka; Torgeir B Wyller Journal: Crit Rev Oncol Hematol Date: 2009-12-14 Impact factor: 6.312
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: Thomas N Robinson; Daniel S Wu; Lauren Pointer; Christina L Dunn; Joseph C Cleveland; Marc Moss Journal: Am J Surg Date: 2013-07-20 Impact factor: 2.565
Authors: Anne M Suskind; Louise C Walter; Chengshi Jin; John Boscardin; Saunak Sen; Matthew R Cooperberg; Emily Finlayson Journal: BJU Int Date: 2016-01-17 Impact factor: 5.588
Authors: Thomas N Robinson; Jeremy D Walston; Nathan E Brummel; Stacie Deiner; Charles H Brown; Maura Kennedy; Arti Hurria Journal: J Am Coll Surg Date: 2015-09-11 Impact factor: 6.113
Authors: Martin A Makary; Dorry L Segev; Peter J Pronovost; Dora Syin; Karen Bandeen-Roche; Purvi Patel; Ryan Takenaga; Lara Devgan; Christine G Holzmueller; Jing Tian; Linda P Fried Journal: J Am Coll Surg Date: 2010-04-28 Impact factor: 6.113
Authors: Thomas N Robinson; Ben Eiseman; Jeffrey I Wallace; Skotti D Church; Kim K McFann; Shirley M Pfister; Terra J Sharp; Marc Moss Journal: Ann Surg Date: 2009-09 Impact factor: 12.969
Authors: Thomas N Robinson; Daniel S Wu; Angela Sauaia; Christina L Dunn; Jennifer E Stevens-Lapsley; Marc Moss; Greg V Stiegmann; Csaba Gajdos; Joseph C Cleveland; Sharon K Inouye Journal: Ann Surg Date: 2013-10 Impact factor: 12.969