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Frailty as a Predictor of Outcomes in Subarachnoid Hemorrhage: A Systematic Review and Meta-Analysis

Frailty is an emerging concept in clinical practice used to predict outcomes and dictate treatment algorithms. Frail patients, especially older adults, are at higher risk for adverse outcomes. Aneurysmal subarachnoid hemorrhage (aSAH) is a neurosurgical emergency associated with high morbidity and m...

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Autores principales: Fortunato, Michael, Lin, Fangyi, Uddin, Anaz, Subah, Galadu, Patel, Rohan, Feldstein, Eric, Lui, Aiden, Dominguez, Jose, Merckling, Matthew, Xu, Patricia, McIntyre, Matthew, Gandhi, Chirag, Al-Mufti, Fawaz
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10605612/
https://www.ncbi.nlm.nih.gov/pubmed/37891864
http://dx.doi.org/10.3390/brainsci13101498
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author Fortunato, Michael
Lin, Fangyi
Uddin, Anaz
Subah, Galadu
Patel, Rohan
Feldstein, Eric
Lui, Aiden
Dominguez, Jose
Merckling, Matthew
Xu, Patricia
McIntyre, Matthew
Gandhi, Chirag
Al-Mufti, Fawaz
author_facet Fortunato, Michael
Lin, Fangyi
Uddin, Anaz
Subah, Galadu
Patel, Rohan
Feldstein, Eric
Lui, Aiden
Dominguez, Jose
Merckling, Matthew
Xu, Patricia
McIntyre, Matthew
Gandhi, Chirag
Al-Mufti, Fawaz
author_sort Fortunato, Michael
collection PubMed
description Frailty is an emerging concept in clinical practice used to predict outcomes and dictate treatment algorithms. Frail patients, especially older adults, are at higher risk for adverse outcomes. Aneurysmal subarachnoid hemorrhage (aSAH) is a neurosurgical emergency associated with high morbidity and mortality rates that have previously been shown to correlate with frailty. However, the relationship between treatment selection and post-treatment outcomes in frail aSAH patients is not established. We conducted a meta-analysis of the relevant literature in accordance with PRISMA guidelines. We searched PubMed, Embase, Web of Science, and Google Scholar using “Subarachnoid hemorrhage AND frailty” and “subarachnoid hemorrhage AND frail” as search terms. Data on cohort age, frailty measurements, clinical grading systems, and post-treatment outcomes were extracted. Of 74 studies identified, four studies were included, with a total of 64,668 patients. Percent frailty was 30.4% under a random-effects model in all aSAH patients (p < 0.001). Overall mortality rate of aSAH patients was 11.7% when using a random-effects model (p < 0.001). There was no significant difference in mortality rate between frail and non-frail aSAH patients, but this analysis only included two studies and should be interpreted cautiously. Age and clinical grading, rather than frailty, independently predicted outcomes and mortality in aSAH patients.
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spelling pubmed-106056122023-10-28 Frailty as a Predictor of Outcomes in Subarachnoid Hemorrhage: A Systematic Review and Meta-Analysis Fortunato, Michael Lin, Fangyi Uddin, Anaz Subah, Galadu Patel, Rohan Feldstein, Eric Lui, Aiden Dominguez, Jose Merckling, Matthew Xu, Patricia McIntyre, Matthew Gandhi, Chirag Al-Mufti, Fawaz Brain Sci Systematic Review Frailty is an emerging concept in clinical practice used to predict outcomes and dictate treatment algorithms. Frail patients, especially older adults, are at higher risk for adverse outcomes. Aneurysmal subarachnoid hemorrhage (aSAH) is a neurosurgical emergency associated with high morbidity and mortality rates that have previously been shown to correlate with frailty. However, the relationship between treatment selection and post-treatment outcomes in frail aSAH patients is not established. We conducted a meta-analysis of the relevant literature in accordance with PRISMA guidelines. We searched PubMed, Embase, Web of Science, and Google Scholar using “Subarachnoid hemorrhage AND frailty” and “subarachnoid hemorrhage AND frail” as search terms. Data on cohort age, frailty measurements, clinical grading systems, and post-treatment outcomes were extracted. Of 74 studies identified, four studies were included, with a total of 64,668 patients. Percent frailty was 30.4% under a random-effects model in all aSAH patients (p < 0.001). Overall mortality rate of aSAH patients was 11.7% when using a random-effects model (p < 0.001). There was no significant difference in mortality rate between frail and non-frail aSAH patients, but this analysis only included two studies and should be interpreted cautiously. Age and clinical grading, rather than frailty, independently predicted outcomes and mortality in aSAH patients. MDPI 2023-10-23 /pmc/articles/PMC10605612/ /pubmed/37891864 http://dx.doi.org/10.3390/brainsci13101498 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Systematic Review
Fortunato, Michael
Lin, Fangyi
Uddin, Anaz
Subah, Galadu
Patel, Rohan
Feldstein, Eric
Lui, Aiden
Dominguez, Jose
Merckling, Matthew
Xu, Patricia
McIntyre, Matthew
Gandhi, Chirag
Al-Mufti, Fawaz
Frailty as a Predictor of Outcomes in Subarachnoid Hemorrhage: A Systematic Review and Meta-Analysis
title Frailty as a Predictor of Outcomes in Subarachnoid Hemorrhage: A Systematic Review and Meta-Analysis
title_full Frailty as a Predictor of Outcomes in Subarachnoid Hemorrhage: A Systematic Review and Meta-Analysis
title_fullStr Frailty as a Predictor of Outcomes in Subarachnoid Hemorrhage: A Systematic Review and Meta-Analysis
title_full_unstemmed Frailty as a Predictor of Outcomes in Subarachnoid Hemorrhage: A Systematic Review and Meta-Analysis
title_short Frailty as a Predictor of Outcomes in Subarachnoid Hemorrhage: A Systematic Review and Meta-Analysis
title_sort frailty as a predictor of outcomes in subarachnoid hemorrhage: a systematic review and meta-analysis
topic Systematic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10605612/
https://www.ncbi.nlm.nih.gov/pubmed/37891864
http://dx.doi.org/10.3390/brainsci13101498
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