Key result
Frailty on the Clinical Frailty Scale is linked to ~301% higher mortality in older surgical patients.
Why the study?
While frailty predicts postoperative adverse outcomes across various tools, the specific predictive efficacy of the Clinical Frailty Scale for postoperative mortality in older surgical patients needed systematic evaluation.
Does frailty assessed by the Clinical Frailty Scale predict postoperative mortality in older surgical patients?
Meta-Analysis (n=5,864)
Does frailty assessed by the Clinical Frailty Scale predict postoperative mortality in older surgical patients?
The Clinical Frailty Scale is an effective tool for predicting postoperative mortality in older surgical patients, with frail patients having a four-fold higher risk of death.
Supports preoperative frailty assessment with CFS; leaves open whether frailty-targeted interventions reduce mortality.
• The prediction of frailty on postoperative adverse outcomes has been confirmed, but there are various assessment tools for frailty. This study only studied the prediction of clinical frailty scale on postoperative adverse outcomes. At the same time, we further analyzed different death time, literature types, surgical types, etc., to verify the effect of clinical frailty scale on postoperative mortality. To systematically evaluate the predictive efficacy of clinical frailty scale (CFS) for postoperative mortality older surgical patients, and to evaluate the prevalence of frailty in the included studies. A systematic review and meta-analysis of observational studies was conducted, utilizing the MOOSE guidelines for the evaluation of both. Quality assessment of the articles was also performed. The protocol was registered (CRD42023423552). Relevant English and Chinese language studies published until October 20th, 2023 were retrieved from PubMed, Web of Science, Embase, Medline, CINAHL,Cochrane, WAN FANG DATA, VIP Information, CNKI, and SinoMed databases. Study were included in which frailty was measured by the CFS and postoperative mortality was reported for older surgery patients. A meta-analysis to predict postoperative mortality and frailty prevalence was performed using STATA 17.0 software. Sixteen cohort studies were included (5,864 participants) from 1,513 records. All studies' Newcastle-Ottawa Scale (NOS) scores were above 6 points. It was found that the prevalence of surgical frailty in the older was 0.36(CI 0.20–0.52). Patients assessed as frail by the CFS were associated with higher all-cause mortality (OR:4.01; CI 2.59–6.23). Subgroup analysis shows that frailty was associated with1-month mortality (OR:3.85; CI 1.11–13.45) and 1-year mortality (OR:4.43; CI 2.18–8.99). The prevalence of frailty is high in older surgical patients, and CFS can effectively predict the mortality of older surgical patients with frailty.
No takes yet. Share an insight, caveat, or question.
Zhang et al. (2024) conducted a meta-analysis in older surgical patients (n=5,864). Frailty (Clinical Frailty Scale) vs. Non-frail was evaluated on all-cause mortality (OR 4.01, 95% CI 2.59-6.23). Frailty assessed by the Clinical Frailty Scale in older surgical patients was associated with higher all-cause mortality (OR 4.01; 95% CI 2.59-6.23).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: