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Open Access 01-12-2024 | Craniotomy | Research

Association between frailty and clinical outcomes in patients undergoing craniotomy—systematic review and meta-analysis of observational studies

Authors: Ana Licina, Andrew Silvers, Christopher Thien

Published in: Systematic Reviews | Issue 1/2024

Abstract

Background

Frailty in patients undergoing craniotomy may affect perioperative outcomes. There have been a number of studies published in this field; however, evidence is yet to be summarized in a quantitative review format. We conducted a systematic review and meta-analysis to examine the effects of frailty on perioperative outcomes in patients undergoing craniotomy surgery.

Methods

Our eligibility criteria included adult patients undergoing open cranial surgery. We searched MEDLINE via Ovid SP, EMBASE via Ovid SP, Cochrane Library, and grey literature. We included retrospective and prospective observational studies. Our primary outcome was a composite of complications as per the Clavien–Dindo classification system. We utilized a random-effects model of meta-analysis. We conducted three preplanned subgroup analyses: patients undergoing cranial surgery for tumor surgery only, patients undergoing non-tumor surgery, and patients older than 65 undergoing cranial surgery. We explored sources of heterogeneity through a sensitivity analysis and post hoc analysis.

Results

In this review of 63,159 patients, the pooled prevalence of frailty was 46%. The odds ratio of any Clavien–Dindo grade 1–4 complication developing in frail patients compared to non-frail patients was 2.01 [1.90–2.14], with no identifiable heterogeneity and a moderate level of evidence. As per GradePro evidence grading methods, there was low-quality evidence for patients being discharged to a location other than home, length of stay, and increased mortality in frail patients.

Conclusion

Increased frailty was associated with increased odds of any Clavien–Dindo 1-4 complication. Frailty measurements may be used as an integral component of risk-assessment strategies to improve the quality and value of neurosurgical care for patients undergoing craniotomy surgery.

Ethics and dissemination

Formal ethical approval is not needed, as primary data were not collected.

Systematic review registration

PROSPERO identification number: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=405240

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Title: Association between frailty and clinical outcomes in patients undergoing craniotomy—systematic review and meta-analysis of observational studies
Authors: Ana Licina
Andrew Silvers
Christopher Thien
Publication date: 01-12-2024
Publisher: BioMed Central
Keywords: Craniotomy
Cranial Surgery
Published in: Systematic Reviews / Issue 1/2024
Electronic ISSN: 2046-4053
DOI: https://doi.org/10.1186/s13643-024-02479-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Association between frailty and clinical outcomes in patients undergoing craniotomy—systematic review and meta-analysis of observational studies

Abstract

Background

Methods

Results

Conclusion

Ethics and dissemination

Systematic review registration

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

Ethics and dissemination

Systematic review registration

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