期刊
ANNALS OF THE ROYAL COLLEGE OF SURGEONS OF ENGLAND
卷 98, 期 2, 页码 80-85出版社
ROYAL COLL SURGEONS ENGLAND
DOI: 10.1308/rcsann.2016.0048
关键词
Frailty; Elderly; Postoperative outcomes; Mortality rates; Sarcopenia
类别
资金
- Medical Research Council [U1052 60558, G0800860]
- MRC [MC_UP_1302/2, MC_U105260558, MC_UU_00002/3] Funding Source: UKRI
- Medical Research Council [MC_UU_00002/3, MC_UP_1302/2, MC_U105260558] Funding Source: researchfish
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% Cl: 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.
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