Effects of Frailty on Outcomes Following Surgery Among Patients With Hip Fractures: A Systematic Review and Meta-Analysis
BackgroundFrailty is a syndrome of multisystem dysfunction in the elderly. The association between preoperative frailty and postoperative outcomes in patients with hip fractures is unclear. To address this issue, we performed a meta-analysis to determine the association of frailty with postoperative...
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Frontiers Media S.A.
2022-03-01
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| Series: | Frontiers in Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2022.829762/full |
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| author | Yan Ma Yan Ma Ansu Wang Yijiao Lou Daojuan Peng Zhongyan Jiang Tongxia Xia Tongxia Xia |
| author_facet | Yan Ma Yan Ma Ansu Wang Yijiao Lou Daojuan Peng Zhongyan Jiang Tongxia Xia Tongxia Xia |
| author_sort | Yan Ma |
| collection | DOAJ |
| description | BackgroundFrailty is a syndrome of multisystem dysfunction in the elderly. The association between preoperative frailty and postoperative outcomes in patients with hip fractures is unclear. To address this issue, we performed a meta-analysis to determine the association of frailty with postoperative mortality, complications, and readmission in patients with hip fractures.MethodsWe searched PubMed, Web of Science, Embase, and The Cochrane Library for cohort studies of frailty associated with postoperative adverse events in patients with hip fractures from inception to November 6, 2021. The Newcastle-Ottawa Scale was used to evaluate the quality of the included literature. Statistical analysis of meta-analysis was performed using Review Manager 5.3.ResultsTwelve retrospective cohort studies and seven prospective cohort studies involving a total of 62,132 patients met the inclusion criteria for this meta-analysis. Compared with non-frail patients, the pooled results showed that frailty was associated with patient in-hospital mortality (relative risk [RR] = 2.93; 95% confidence intervals [CI]: 2.56–3.34), 30-day mortality (RR = 2.85, 95%CI: 1.67–4.85) and total complications (RR = 1.79, 95%CI: 1.50–2.15). Subgroup analysis showed that the type of study design and frailty assessment tool had no significant effect on the results. Sensitivity analysis showed that the polled results of frailty predicted one-year mortality and 30-day readmission was unstable.ConclusionsIn this meta-analysis, we found that preoperative frailty may be associated with postoperative adverse events in patients with hip fractures, including in-hospital mortality, 30-day mortality, and postoperative complications.Systematic Review Registration: PROSPERO, identifier: CRD42021287739. |
| first_indexed | 2024-04-13T10:23:47Z |
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| language | English |
| last_indexed | 2024-04-13T10:23:47Z |
| publishDate | 2022-03-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Medicine |
| spelling | doaj.art-3fe91ba104554290b3867f4604247c442022-12-22T02:50:22ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2022-03-01910.3389/fmed.2022.829762829762Effects of Frailty on Outcomes Following Surgery Among Patients With Hip Fractures: A Systematic Review and Meta-AnalysisYan Ma0Yan Ma1Ansu Wang2Yijiao Lou3Daojuan Peng4Zhongyan Jiang5Tongxia Xia6Tongxia Xia7Department of Orthopaedic Surgery, Affiliated Hospital of Zunyi Medical University, Zunyi, ChinaNursing School, Zunyi Medical University, Zunyi, ChinaDepartment of Orthopaedic Surgery, Affiliated Hospital of Zunyi Medical University, Zunyi, ChinaNursing School, Zunyi Medical University, Zunyi, ChinaNursing School, Zunyi Medical University, Zunyi, ChinaDepartment of Orthopaedic Surgery, Affiliated Hospital of Zunyi Medical University, Zunyi, ChinaNursing School, Zunyi Medical University, Zunyi, ChinaDepartment of Nursing, Affiliated Hospital of Zunyi Medical University, Zunyi, ChinaBackgroundFrailty is a syndrome of multisystem dysfunction in the elderly. The association between preoperative frailty and postoperative outcomes in patients with hip fractures is unclear. To address this issue, we performed a meta-analysis to determine the association of frailty with postoperative mortality, complications, and readmission in patients with hip fractures.MethodsWe searched PubMed, Web of Science, Embase, and The Cochrane Library for cohort studies of frailty associated with postoperative adverse events in patients with hip fractures from inception to November 6, 2021. The Newcastle-Ottawa Scale was used to evaluate the quality of the included literature. Statistical analysis of meta-analysis was performed using Review Manager 5.3.ResultsTwelve retrospective cohort studies and seven prospective cohort studies involving a total of 62,132 patients met the inclusion criteria for this meta-analysis. Compared with non-frail patients, the pooled results showed that frailty was associated with patient in-hospital mortality (relative risk [RR] = 2.93; 95% confidence intervals [CI]: 2.56–3.34), 30-day mortality (RR = 2.85, 95%CI: 1.67–4.85) and total complications (RR = 1.79, 95%CI: 1.50–2.15). Subgroup analysis showed that the type of study design and frailty assessment tool had no significant effect on the results. Sensitivity analysis showed that the polled results of frailty predicted one-year mortality and 30-day readmission was unstable.ConclusionsIn this meta-analysis, we found that preoperative frailty may be associated with postoperative adverse events in patients with hip fractures, including in-hospital mortality, 30-day mortality, and postoperative complications.Systematic Review Registration: PROSPERO, identifier: CRD42021287739.https://www.frontiersin.org/articles/10.3389/fmed.2022.829762/fullfrailtyhip fracturesmortalitypostoperative complicationsmeta-analysis |
| spellingShingle | Yan Ma Yan Ma Ansu Wang Yijiao Lou Daojuan Peng Zhongyan Jiang Tongxia Xia Tongxia Xia Effects of Frailty on Outcomes Following Surgery Among Patients With Hip Fractures: A Systematic Review and Meta-Analysis Frontiers in Medicine frailty hip fractures mortality postoperative complications meta-analysis |
| title | Effects of Frailty on Outcomes Following Surgery Among Patients With Hip Fractures: A Systematic Review and Meta-Analysis |
| title_full | Effects of Frailty on Outcomes Following Surgery Among Patients With Hip Fractures: A Systematic Review and Meta-Analysis |
| title_fullStr | Effects of Frailty on Outcomes Following Surgery Among Patients With Hip Fractures: A Systematic Review and Meta-Analysis |
| title_full_unstemmed | Effects of Frailty on Outcomes Following Surgery Among Patients With Hip Fractures: A Systematic Review and Meta-Analysis |
| title_short | Effects of Frailty on Outcomes Following Surgery Among Patients With Hip Fractures: A Systematic Review and Meta-Analysis |
| title_sort | effects of frailty on outcomes following surgery among patients with hip fractures a systematic review and meta analysis |
| topic | frailty hip fractures mortality postoperative complications meta-analysis |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2022.829762/full |
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