Ma Yan, Wang Ansu, Lou Yijiao, Peng Daojuan, Jiang Zhongyan, Xia Tongxia
Department of Orthopaedic Surgery, Affiliated Hospital of Zunyi Medical University, Zunyi, China.
Nursing School, Zunyi Medical University, Zunyi, China.
Front Med (Lausanne). 2022 Mar 23;9:829762. doi: 10.3389/fmed.2022.829762. eCollection 2022.
Frailty 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.
We 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.
Twelve 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.
In 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. PROSPERO, identifier: CRD42021287739.
衰弱是老年人多系统功能障碍的一种综合征。髋部骨折患者术前衰弱与术后结局之间的关联尚不清楚。为解决这一问题，我们进行了一项荟萃分析，以确定衰弱与髋部骨折患者术后死亡率、并发症及再入院之间的关联。
我们检索了PubMed、科学网、Embase和考克兰图书馆，查找从创刊至2021年11月6日关于髋部骨折患者衰弱与术后不良事件相关的队列研究。采用纽卡斯尔-渥太华量表评估纳入文献的质量。使用Review Manager 5.3进行荟萃分析的统计分析。
12项回顾性队列研究和7项前瞻性队列研究，共纳入62132例患者，符合本荟萃分析的纳入标准。汇总结果显示，与非衰弱患者相比，衰弱与患者住院死亡率（相对危险度[RR]=2.93；95%置信区间[CI]：2.56-3.34）、30天死亡率（RR=2.85，95%CI：1.67-4.85）及总并发症（RR=1.79，95%CI：1.50-2.15）相关。亚组分析显示，研究设计类型和衰弱评估工具对结果无显著影响。敏感性分析显示，衰弱预测1年死亡率和30天再入院的汇总结果不稳定。
在本荟萃分析中，我们发现术前衰弱可能与髋部骨折患者术后不良事件相关，包括住院死亡率、30天死亡率和术后并发症。国际前瞻性系统评价注册库（PROSPERO）标识符：CRD42021287739。
