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European Journal of Trauma and Emergency Surgery

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Open Access 01-02-2022 | Basic Surgery | Original Article

Association between mortality and frailty in emergency general surgery: a systematic review and meta-analysis

Authors: Christophe Alain Fehlmann, Dilan Patel, Jessica McCallum, Jeffrey Joseph Perry, Debra Eagles

Published in: European Journal of Trauma and Emergency Surgery | Issue 1/2022

Abstract

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).

Available only for authorised users

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Title: Association between mortality and frailty in emergency general surgery: a systematic review and meta-analysis
Authors: Christophe Alain Fehlmann
Dilan Patel
Jessica McCallum
Jeffrey Joseph Perry
Debra Eagles
Publication date: 01-02-2022
Publisher: Springer Berlin Heidelberg
Keyword: Basic Surgery
Published in: European Journal of Trauma and Emergency Surgery / Issue 1/2022
Print ISSN: 1863-9933
Electronic ISSN: 1863-9941
DOI: https://doi.org/10.1007/s00068-020-01578-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Association between mortality and frailty in emergency general surgery: a systematic review and meta-analysis

Abstract

Purpose

Methods

Results

Conclusion

Registration number

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Registration number

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