Xiang Qiuyan, Luo Sha, Chen Guangyao, Liu Yiwen
Department of Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, 610041, China.
Department of Orthopedics, West China Hospital, Sichuan University, Sichuan University, Chengdu, 610041, China.
Neurosurg Rev. 2025 Jul 10;48(1):555. doi: 10.1007/s10143-025-03693-w.
Frailty, a multidimensional syndrome associated with decreased physiological reserve, may influence survival outcomes in patients with glioma. This meta-analysis aimed to evaluate the association between frailty and survival outcomes in glioma patients, with implications for nursing and clinical practice.
This meta-analysis included cohort studies investigating frailty and survival in glioma patients. Comprehensive searches were conducted in PubMed, Embase, and Web of Science up to October 2024. Hazard ratios (HRs) with 95% confidence intervals (CIs) were pooled using a random-effects model. Sensitivity analyses using a leave-one-out approach were performed to evaluate the robustness of the finding. Subgroup and meta-regression analyses were performed to evaluate the influence of study characteristics on the outcome.
Eleven cohort studies involving 2,519 patients were included. Frailty was significantly associated with poorer overall survival (OS) in glioma patients (HR: 1.47, 95% CI: 1.25-1.74, p < 0.001) with moderate heterogeneity (p for Cochrane Q test = 0.12, I² = 35%). Subgroup analyses revealed consistent results across tumor grades (p = 0.92), primary treatments (p = 0.82), age groups (p = 0.14), proportion of men (p = 0.23), frailty assessment methods (p = 0.43), follow-up durations (p = 0.25), analytic models (p = 0.30), and study quality scores (p = 0.21). Meta-regression did not show a significant influence of sample size, mean age, sex, follow-up duration, or study quality score on the association (p all > 0.05). Frailty was also associated with shorter progression-free survival (HR: 1.20, 95% CI: 1.06-1.36, p = 0.004) with mild heterogeneity (p for Cochrane Q test = 0.41, I² = 0%).
Frailty appears to be a significant predictor of poorer survival in glioma patients, underscoring its importance in clinical decision-making and patient care. Integrating frailty assessments into nursing and treatment protocols could improve outcome predictions and tailored interventions.
衰弱是一种与生理储备下降相关的多维综合征，可能会影响胶质瘤患者的生存结局。本荟萃分析旨在评估衰弱与胶质瘤患者生存结局之间的关联，为护理和临床实践提供参考。
本荟萃分析纳入了调查胶质瘤患者衰弱与生存情况的队列研究。截至2024年10月，在PubMed、Embase和Web of Science数据库中进行了全面检索。采用随机效应模型汇总95%置信区间（CI）的风险比（HR）。采用逐一剔除法进行敏感性分析，以评估研究结果的稳健性。进行亚组分析和Meta回归分析，以评估研究特征对结果的影响。
纳入了11项涉及2519例患者的队列研究。衰弱与胶质瘤患者较差的总生存期（OS）显著相关（HR：1.47，95%CI：1.25-1.74，p<0.001），异质性中等（Cochrane Q检验p=0.12，I²=35%）。亚组分析显示，在肿瘤分级（p=0.92）、初始治疗（p=0.82）、年龄组（p=0.14）、男性比例（p=0.23）、衰弱评估方法（p=0.43）、随访时间（p=0.25）、分析模型（p=0.30）和研究质量评分（p=0.21）方面结果一致。Meta回归分析未显示样本量、平均年龄、性别、随访时间或研究质量评分对该关联有显著影响（所有p>0.05）。衰弱还与较短的无进展生存期相关（HR：1.20，95%CI：1.06-1.36，p=0.004），异质性较小（Cochrane Q检验p=0.41，I²=0%）。
衰弱似乎是胶质瘤患者生存较差的重要预测因素，强调了其在临床决策和患者护理中的重要性。将衰弱评估纳入护理和治疗方案可改善结局预测并进行个性化干预。
