Effects of preoperative frailty on outcomes following surgery among patients with digestive system tumors: A systematic review and meta-analysis

Ding, Lei; Lu, Jinling; Zhu, Hanfei; Zhu, Shuqin; Xu, Xinyi; Hua, Hongxia; Chen, Li; Zhao, Kang; Xu, Qi

doi:10.1016/j.ejso.2021.07.019

Cited by 16 publications

(6 citation statements)

References 42 publications

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“…This meta-analysis showed that preoperative frailty was associated with postoperative hospital mortality and 30-day mortality, independent of study type and frailty assessment tools. The results are consistent with studies of patients with other conditions that require surgery, including lung cancer and digestive tumors ( 38 , 39 ). However, the association between frailty and one-year mortality is uncertain, this may be due to the different selection of confounding factors in different studies.…”

Section: Discussionsupporting

confidence: 88%

Effects of Frailty on Outcomes Following Surgery Among Patients With Hip Fractures: A Systematic Review and Meta-Analysis

Wang

Lou

et al. 2022

Front. Med.

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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.

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Section: Discussionsupporting

confidence: 88%

Effects of Frailty on Outcomes Following Surgery Among Patients With Hip Fractures: A Systematic Review and Meta-Analysis

Wang

Lou

et al. 2022

Front. Med.

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“…The outcome measures were total complications and increased hospital costs. Only postoperative complications that developed during hospitalisation were considered for total complications [32]. Based on previous studies, total complications were considered as Clavien-Dindo classi cation ≥ 2 [33].…”

Section: Outcome Measuresmentioning

confidence: 99%

Predictive value of frailty assessment tools in patients undergoing surgery for gastrointestinal cancer

Hui-pin

Zhang

Zhou

et al. 2022

Preprint

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Purpose We used three commonly used frailty assessment tools to investigate the current status of preoperative frailty and to analyse their predictive value for prognosis in patients undergoing surgery for gastrointestinal cancer. Methods This single-centre, observational, prospective cohort study was conducted at the Affiliated Lianyungang Hospital of Xuzhou Medical University from August 2021 to July 2022. A total of 229 patients aged ≥ 18 years who underwent surgery for gastrointestinal cancer were included in this study. We collected the patients’ baseline data and used the Comprehensive Geriatric Assessment (CGA), Fried Phenotype (FP), and the FRAIL scale to assess frailty. The outcome measures were the complications experienced by patients and increased hospital costs. Results The prevalence of frailty was assessed using the CGA, FP, and FRAIL scale which returned the results 65.9%, 47.6%, and 34.9%, respectively. Multivariate logistic analysis confirmed that CGA was independently associated with increased hospital costs (OR = 2.514, 95% CI [1.202–5.258]; p = 0.014), and none of the frailty assessment tools were associated with total complications. Conclusions CGA was an independent predictor of increased hospital costs in patients undergoing surgery for gastrointestinal cancer.

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“…For example, a systematic review and meta-analysis by Boakye et al [ 29 ] showed that frailty was a strong prognostic factor of survival in colorectal carcinoma patients. Another systematic review and meta-analysis by Ding et al [ 30 ] found that preoperative frailty was associated with an increased risk of postoperative complications and mortality in patients with digestive system tumors. Furthermore, Kwon et al [ 31 ] reported the importance of utilizing a frailty screening tool focused on respiratory and swallowing functions in older patients with head and neck cancer as this patient population had an increased risk of developing functional disabilities associated with respiration and swallowing that significantly affected early morbidity and mortality.…”

Section: Cancer and Frailtymentioning

confidence: 99%

Brain Prehabilitation for Oncologic Surgery

et al. 2022

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Purpose of Review This review aims to summarize the current research on postoperative cognitive complications, such as delirium and cognitive dysfunction. This includes discussion on preoperative preventive strategies, such as physical and nutritional prehabilitation as well as up-to-date information on neuroprehabilitation. Recent Findings Current recommendations for prevention of postoperative delirium have focused on multicomponent interventions. The optimal composition of surgical prehabilitation programs targeting exercise and nutrition has not yet been established. The Neurobics Trial shows that cognitive prehabilitation improves cognitive reserve and may be a useful addition to multimodal surgical prehabilitation. Summary Perioperative management of oncologic patients is often associated with a myriad of challenges, such as the management of tumor-related pathologies, adverse events from neoadjuvant therapy, and chronic metabolic and immunological changes associated with malignancy. In addition, oncologic patients are at increased risk of developing frailty, which adversely affects postoperative recovery and further cancer treatment. As a result, oncologic patients are at considerable risk of developing postoperative cognitive complications, such as delirium and cognitive dysfunction. In this review, we discuss the effect of prehabilitation on postoperative cognitive outcomes.

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Effects of preoperative frailty on outcomes following surgery among patients with digestive system tumors: A systematic review and meta-analysis

Cited by 16 publications

References 42 publications

Effects of Frailty on Outcomes Following Surgery Among Patients With Hip Fractures: A Systematic Review and Meta-Analysis

Effects of Frailty on Outcomes Following Surgery Among Patients With Hip Fractures: A Systematic Review and Meta-Analysis

Predictive value of frailty assessment tools in patients undergoing surgery for gastrointestinal cancer

Brain Prehabilitation for Oncologic Surgery

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