Cargando…
Association between mortality and frailty in emergency general surgery: a systematic review and meta-analysis
PURPOSE: The purpose of this review was to determine the association between frailty and mortality among adults ≥ 65 years old undergoing emergency general surgery (EGS). METHODS: This systematic review followed the PRISMA guidelines (CRD42020172482 on PROSPERO). A search in MEDLINE, PubMed, EMBASE,...
Autores principales: | , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Berlin Heidelberg
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8825621/ https://www.ncbi.nlm.nih.gov/pubmed/33423069 http://dx.doi.org/10.1007/s00068-020-01578-9 |
_version_ | 1784647256880709632 |
---|---|
author | Fehlmann, Christophe Alain Patel, Dilan McCallum, Jessica Perry, Jeffrey Joseph Eagles, Debra |
author_facet | Fehlmann, Christophe Alain Patel, Dilan McCallum, Jessica Perry, Jeffrey Joseph Eagles, Debra |
author_sort | Fehlmann, Christophe Alain |
collection | PubMed |
description | PURPOSE: The purpose of this review was to determine the association between frailty and mortality among adults ≥ 65 years old undergoing emergency general surgery (EGS). METHODS: This systematic review followed the PRISMA guidelines (CRD42020172482 on PROSPERO). A search in MEDLINE, PubMed, EMBASE, Scopus, Web of Science, and the Cochrane Database of Systematic Reviews was conducted from inception to March 5, 2020. Studies with patients ≥ 65 years undergoing EGS were included. The primary exposure was frailty, measured using the Clinical Frailty Scale or the Modified Frailty Index. The primary outcome was 30-day mortality. Secondary outcomes were 90-day and 1-year mortality, length of stay, complications, change in level of care at discharge, and loss of independence. Two independent reviewers screened articles and extracted data. Risk of bias was assessed according to the Newcastle–Ottawa Scale and quality of evidence was assessed using the GRADE approach. A meta-analysis was performed for 30-day mortality using a random-effects model. RESULTS: Our search yielded 847 articles and six cohort studies were included in the systematic review. There were 1289 patients, 283 being frail. The pooled OR from meta-analysis for frail compared to non-frail patients was 2.91 (95% CI 2.00, 4.23) for 30-day mortality. Frailty was associated with increased odds of all secondary outcomes. CONCLUSION: Frailty is significantly associated with worse outcomes after emergency general surgery in adults ≥ 65 years of age. The Clinical Frailty Scale could be used to improve preoperative risk assessment for patients and shared decision-making between patients and healthcare providers. REGISTRATION NUMBER: CRD42020172482 (PROSPERO). SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00068-020-01578-9. |
format | Online Article Text |
id | pubmed-8825621 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
spelling | pubmed-88256212022-02-23 Association between mortality and frailty in emergency general surgery: a systematic review and meta-analysis Fehlmann, Christophe Alain Patel, Dilan McCallum, Jessica Perry, Jeffrey Joseph Eagles, Debra Eur J Trauma Emerg Surg Original Article PURPOSE: The purpose of this review was to determine the association between frailty and mortality among adults ≥ 65 years old undergoing emergency general surgery (EGS). METHODS: This systematic review followed the PRISMA guidelines (CRD42020172482 on PROSPERO). A search in MEDLINE, PubMed, EMBASE, Scopus, Web of Science, and the Cochrane Database of Systematic Reviews was conducted from inception to March 5, 2020. Studies with patients ≥ 65 years undergoing EGS were included. The primary exposure was frailty, measured using the Clinical Frailty Scale or the Modified Frailty Index. The primary outcome was 30-day mortality. Secondary outcomes were 90-day and 1-year mortality, length of stay, complications, change in level of care at discharge, and loss of independence. Two independent reviewers screened articles and extracted data. Risk of bias was assessed according to the Newcastle–Ottawa Scale and quality of evidence was assessed using the GRADE approach. A meta-analysis was performed for 30-day mortality using a random-effects model. RESULTS: Our search yielded 847 articles and six cohort studies were included in the systematic review. There were 1289 patients, 283 being frail. The pooled OR from meta-analysis for frail compared to non-frail patients was 2.91 (95% CI 2.00, 4.23) for 30-day mortality. Frailty was associated with increased odds of all secondary outcomes. CONCLUSION: Frailty is significantly associated with worse outcomes after emergency general surgery in adults ≥ 65 years of age. The Clinical Frailty Scale could be used to improve preoperative risk assessment for patients and shared decision-making between patients and healthcare providers. REGISTRATION NUMBER: CRD42020172482 (PROSPERO). SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00068-020-01578-9. Springer Berlin Heidelberg 2021-01-09 2022 /pmc/articles/PMC8825621/ /pubmed/33423069 http://dx.doi.org/10.1007/s00068-020-01578-9 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Original Article Fehlmann, Christophe Alain Patel, Dilan McCallum, Jessica Perry, Jeffrey Joseph Eagles, Debra Association between mortality and frailty in emergency general surgery: a systematic review and meta-analysis |
title | Association between mortality and frailty in emergency general surgery: a systematic review and meta-analysis |
title_full | Association between mortality and frailty in emergency general surgery: a systematic review and meta-analysis |
title_fullStr | Association between mortality and frailty in emergency general surgery: a systematic review and meta-analysis |
title_full_unstemmed | Association between mortality and frailty in emergency general surgery: a systematic review and meta-analysis |
title_short | Association between mortality and frailty in emergency general surgery: a systematic review and meta-analysis |
title_sort | association between mortality and frailty in emergency general surgery: a systematic review and meta-analysis |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8825621/ https://www.ncbi.nlm.nih.gov/pubmed/33423069 http://dx.doi.org/10.1007/s00068-020-01578-9 |
work_keys_str_mv | AT fehlmannchristophealain associationbetweenmortalityandfrailtyinemergencygeneralsurgeryasystematicreviewandmetaanalysis AT pateldilan associationbetweenmortalityandfrailtyinemergencygeneralsurgeryasystematicreviewandmetaanalysis AT mccallumjessica associationbetweenmortalityandfrailtyinemergencygeneralsurgeryasystematicreviewandmetaanalysis AT perryjeffreyjoseph associationbetweenmortalityandfrailtyinemergencygeneralsurgeryasystematicreviewandmetaanalysis AT eaglesdebra associationbetweenmortalityandfrailtyinemergencygeneralsurgeryasystematicreviewandmetaanalysis |