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The prevalence of frailty and its association with clinical outcomes in general surgery: a systematic review and meta-analysis

Hewitt, Jonathan, Long, Sara, Carter, Ben, Bach, Simon, McCarthy, Kathryn and Clegg, Andrew 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. 10.1093/ageing/afy110

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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.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
Social Sciences (Includes Criminology and Education)
Publisher: Oxford University Press
ISSN: 0002-0729
Date of First Compliant Deposit: 6 September 2018
Date of Acceptance: 9 May 2018
Last Modified: 18 Oct 2019 07:52
URI: http://orca-mwe.cf.ac.uk/id/eprint/114585

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