Hewitt, J, Long, S, Carter, B et al. (3 more authors) (2018) The prevalence of frailty and its association with clinical outcomes in general surgery: a systematic review and meta-analysis. Age and Ageing, 47 (6). pp. 793-800. ISSN 0002-0729
Abstract
Objectives: to investigate the prevalence and impact of frailty for general surgical patients.
Research design and methods: we conducted a systematic review and meta-analysis. Studies published between 1 January 1980 and 31 August 2017 were searched from seven databases. Incidence of clinical outcomes (mortality at Days 30 and 90; readmission at Day 30, surgical complications and length of stay) were estimated by frailty subgroup (not-frail, pre-frail and frail).
Results: 2,281 participants from nine observational studies were included, 49.3% (1013/2055) were males. Mean age ranged from 61 to 77 years old. Eight studies provided outcome data and were quality assessed and of fair or good quality, and one study only provided an estimate of prevalence and was not quality assessed. The prevalence estimate ranged between 31.3 and 45.8% for pre-frailty, and 10.4 and 37.0% for frailty. After pooling, Day 30 mortality was 8% (95% CI: 4–12%; I2 = 0%) for frail compared to 1% for non-frail patients (95% CI: 0–2%; I2 = 75%). Due to heterogeneity the Day 90 mortality was not pooled. Readmission rates were lower in the non-frail groups but were not pooled. Complications for the frail patients were 24%, (95% CI: 20–31%; I2 = 92%), pre-frail subgroup 9% (95% CI: 5–14%; I2 = 82%) and non-frail 5% (95% CI: 3–7%; I2 = 70%). The mean length of stay in frail people was 9.6 days (95% CI: 6.2–12.9) and 6.4 days (4.9–7.9) non-frail.
Conclusions: frailty is associated with adverse post-operative outcomes in general surgery.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © The Author(s) 2018. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. This is an author produced version of a paper published in Age and Ageing. Uploaded in accordance with the publisher's self-archiving policy. |
Keywords: | frailty; general surgery; meta-analysis; older people; systematic review |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Leeds Institute of Health Sciences (Leeds) > Academic Unit of Elderly Care and Rehabilitation (Leeds) |
Depositing User: | Symplectic Publications |
Date Deposited: | 03 Oct 2018 14:52 |
Last Modified: | 02 Aug 2019 00:43 |
Status: | Published |
Publisher: | Oxford University Press |
Identification Number: | 10.1093/ageing/afy110 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:136589 |