Frailty and Emergency Surgery: Results of a Systematic Review and Meta-Analysis.

Clinical Frailty Scale emergency surgery frail adults meta-analysis mortality

Journal

Frontiers in medicine
ISSN: 2296-858X
Titre abrégé: Front Med (Lausanne)
Pays: Switzerland
ID NLM: 101648047

Informations de publication

Date de publication:
2022
Historique:
received: 08 11 2021
accepted: 08 02 2022
entrez: 18 4 2022
pubmed: 19 4 2022
medline: 19 4 2022
Statut: epublish

Résumé

Frailty, a "syndrome of loss of reserves," is a decade old concept. Initially it was used mainly in geriatrics but lately its use has been extended into other specialties including surgery. Our main objective was to examine the association between frailty and mortality, between frailty and length of hospital stay (LOS) and frailty and readmission within 30 days in the emergency surgical population. Studies reporting on frailty in the emergency surgical population were eligible. MEDLINE (via PubMed), EMBASE, Scopus, CENTRAL, and Web of Science were searched with terms related to acute surgery and frail At the end of the selection process 21 eligible studies with total 562.070 participants from 8 countries were included in the qualitative and the quantitative synthesis. Patients living with frailty have higher chance of dying within 30 days after an emergency surgical admission (OR: 1.99; CI: 1.76-2.21; Although there is good evidence that living with frailty increases the chance of unfavorable outcomes, further research needs to be done to assess the benefits and costs of frailty screening for emergency surgical patients. The review protocol was registered on the PROSPERO International Prospective Register of Systematic Reviews (CRD42021224689).

Sections du résumé

Background UNASSIGNED
Frailty, a "syndrome of loss of reserves," is a decade old concept. Initially it was used mainly in geriatrics but lately its use has been extended into other specialties including surgery. Our main objective was to examine the association between frailty and mortality, between frailty and length of hospital stay (LOS) and frailty and readmission within 30 days in the emergency surgical population.
Methods UNASSIGNED
Studies reporting on frailty in the emergency surgical population were eligible. MEDLINE (via PubMed), EMBASE, Scopus, CENTRAL, and Web of Science were searched with terms related to acute surgery and frail
Results UNASSIGNED
At the end of the selection process 21 eligible studies with total 562.070 participants from 8 countries were included in the qualitative and the quantitative synthesis. Patients living with frailty have higher chance of dying within 30 days after an emergency surgical admission (OR: 1.99; CI: 1.76-2.21;
Conclusions UNASSIGNED
Although there is good evidence that living with frailty increases the chance of unfavorable outcomes, further research needs to be done to assess the benefits and costs of frailty screening for emergency surgical patients.
Systematic Review Registration UNASSIGNED
The review protocol was registered on the PROSPERO International Prospective Register of Systematic Reviews (CRD42021224689).

Identifiants

pubmed: 35433739
doi: 10.3389/fmed.2022.811524
pmc: PMC9008569
doi:

Types de publication

Systematic Review

Langues

eng

Pagination

811524

Informations de copyright

Copyright © 2022 Leiner, Nemeth, Hegyi, Ocskay, Virag, Kiss, Rottler, Vajda, Varadi and Molnar.

Déclaration de conflit d'intérêts

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Références

Clin Gastroenterol Hepatol. 2021 Oct;19(10):2054-2063.e14
pubmed: 32801013
Surgery. 2010 Aug;148(2):217-38
pubmed: 20633727
World J Emerg Surg. 2019 Dec 30;14:62
pubmed: 31892937
BMC Surg. 2021 Jan 26;21(1):62
pubmed: 33499844
J Am Geriatr Soc. 2019 Feb;67(2):309-316
pubmed: 30298686
J Geriatr Oncol. 2016 Nov;7(6):479-491
pubmed: 27338516
World J Emerg Surg. 2016 Jul 29;11:36
pubmed: 27478493
Am J Surg. 2019 Aug;218(2):393-400
pubmed: 30509455
Am J Surg. 2020 Oct;220(4):1058-1063
pubmed: 32312476
Arch Gerontol Geriatr. 2015 Nov-Dec;61(3):437-42
pubmed: 26211706
J Trauma Acute Care Surg. 2016 Aug;81(2):254-60
pubmed: 27257694
BMJ. 2003 Sep 6;327(7414):557-60
pubmed: 12958120
Aging Clin Exp Res. 2020 Nov;32(11):2367-2373
pubmed: 32449105
J Am Geriatr Soc. 2020 May;68(5):1037-1043
pubmed: 32043562
J Frailty Aging. 2017;6(4):219-223
pubmed: 29165541
Age Ageing. 2019 May 1;48(3):388-394
pubmed: 30778528
Eur J Trauma Emerg Surg. 2022 Feb;48(1):141-151
pubmed: 33423069
Eur J Trauma Emerg Surg. 2021 Oct;47(5):1613-1619
pubmed: 32036392
Eur J Heart Fail. 2016 Jul;18(7):869-75
pubmed: 27072307
CMAJ. 2005 Aug 30;173(5):489-95
pubmed: 16129869
Ann Surg. 2021 Apr 1;273(4):709-718
pubmed: 31188201
Acta Chir Belg. 2017 Dec;117(6):370-375
pubmed: 28602153
Anesth Analg. 2017 May;124(5):1653-1661
pubmed: 28431425
J Am Coll Surg. 2016 May;222(5):805-13
pubmed: 27113515
CMAJ. 2018 Feb 20;190(7):E184-E190
pubmed: 29565018
Medicine (Baltimore). 2016 Aug;95(35):e4530
pubmed: 27583863
J Trauma Acute Care Surg. 2016 Jul;81(1):122-30
pubmed: 26958792
Am J Surg. 2015 Feb;209(2):254-9
pubmed: 25173599
Eur J Trauma Emerg Surg. 2022 Apr;48(2):1177-1188
pubmed: 33738537
BMJ Open. 2016 Mar 31;6(3):e010126
pubmed: 27033960
J Surg Res. 2019 Jan;233:397-402
pubmed: 30502276
BMJ. 2009 Jul 21;339:b2535
pubmed: 19622551
Age Ageing. 2021 Sep 11;50(5):1719-1727
pubmed: 33744918
BMJ. 2011 Oct 18;343:d5928
pubmed: 22008217
Arch Gerontol Geriatr. 2018 May - Jun;76:54-59
pubmed: 29459245
Cureus. 2020 Aug 26;12(8):e10048
pubmed: 32983738
Ann Intern Med. 2013 Feb 19;158(4):280-6
pubmed: 23420236
Injury. 2018 Dec;49(12):2234-2238
pubmed: 30274754
Biometrics. 1977 Mar;33(1):159-74
pubmed: 843571
Br J Surg. 2020 Sep;107(10):1363-1371
pubmed: 32639045
J Trauma Acute Care Surg. 2019 Jan;86(1):148-154
pubmed: 30399129

Auteurs

Tamas Leiner (T)

Institute for Translational Medicine, Medical School, University of Pecs, Pecs, Hungary.
Anaesthetic Department, Hinchingbrooke Hospital, North West Anglia NHS Foundation Trust, Huntingdon, United Kingdom.

David Nemeth (D)

Institute for Translational Medicine, Medical School, University of Pecs, Pecs, Hungary.

Peter Hegyi (P)

Institute for Translational Medicine, Medical School, University of Pecs, Pecs, Hungary.
Centre for Translational Medicine, Semmelweis University, Budapest, Hungary.
Division for Pancreatic Disorders, Heart and Vascular Center, Semmelweis University, Budapest, Hungary.

Klementina Ocskay (K)

Institute for Translational Medicine, Medical School, University of Pecs, Pecs, Hungary.
Centre for Translational Medicine, Semmelweis University, Budapest, Hungary.

Marcell Virag (M)

Institute for Translational Medicine, Medical School, University of Pecs, Pecs, Hungary.
Doctoral School of Clinical Medicine, University of Szeged, Szeged, Hungary.
Department of Anesthesiology and Intensive Therapy, Szent Gyorgy University Teaching Hospital of Fejer County, Szekesfehervar, Hungary.

Szabolcs Kiss (S)

Institute for Translational Medicine, Medical School, University of Pecs, Pecs, Hungary.
Doctoral School of Clinical Medicine, University of Szeged, Szeged, Hungary.

Mate Rottler (M)

Institute for Translational Medicine, Medical School, University of Pecs, Pecs, Hungary.
Doctoral School of Clinical Medicine, University of Szeged, Szeged, Hungary.
Department of Anesthesiology and Intensive Therapy, Szent Gyorgy University Teaching Hospital of Fejer County, Szekesfehervar, Hungary.

Matyas Vajda (M)

Institute for Translational Medicine, Medical School, University of Pecs, Pecs, Hungary.
Doctoral School of Clinical Medicine, University of Szeged, Szeged, Hungary.

Alex Varadi (A)

Institute for Translational Medicine, Medical School, University of Pecs, Pecs, Hungary.

Zsolt Molnar (Z)

Institute for Translational Medicine, Medical School, University of Pecs, Pecs, Hungary.
Centre for Translational Medicine, Semmelweis University, Budapest, Hungary.
Department of Anesthesiology and Intensive Therapy, Poznan University of Medical Sciences, Poznan, Poland.
Department of Anesthesiology and Intensive Therapy, Semmelweis University, Budapest, Hungary.

Classifications MeSH