Key result
In a systematic review of 145 studies, preoperative frailty assessment consistently predicted postoperative complications, mortality, and hospital stay across non-cardiac surgical disciplines.
Why the study?
Many tools assess perioperative frailty, but no single scale has been shown to be the most effective in predicting postoperative complications across different non-cardiac surgeries.
Does preoperative frailty predict postoperative complications, mortality, and hospital stay in patients undergoing non-cardiac surgery?
Systematic Review (n=145)
Does preoperative frailty predict postoperative complications, mortality, and hospital stay in patients undergoing non-cardiac surgery?
Preoperative frailty assessment is a consistent predictor of postoperative complications, mortality, and length of stay in patients undergoing non-cardiac surgery.
Supports frailty screening to refine risk estimates before non-cardiac surgery; leaves open which scale is optimal.
OBJECTIVE: Many tools have been used to assess frailty in the perioperative setting. However, no single scale has been shown to be the most effective in predicting postoperative complications. We evaluated the relationship between several frailty scales and the occurrence of complications following different non-cardiac surgeries. METHODS: This systematic review was registered in PROSPERO (CRD42023473401). The search strategy included PubMed, Google Scholar, and Embase, covering manuscripts published from January 2000 to July 2023. We included prospective and retrospective studies that evaluated frailty using specific scales and tracked patients postoperatively. Studies on cardiac, neurosurgical, and thoracic surgery were excluded because of the impact of underlying diseases on patients' functional status. Narrative reviews, conference abstracts, and articles lacking a comprehensive definition of frailty were excluded. RESULTS: Of the 2204 articles identified, 145 were included in the review: 7 on non-cardiac surgery, 36 on general and digestive surgery, 19 on urology, 22 on vascular surgery, 36 on spinal surgery, and 25 on orthopedic/trauma surgery. The reviewed manuscripts confirmed that various frailty scales had been used to predict postoperative complications, mortality, and hospital stay across these surgical disciplines. CONCLUSION: Despite differences among surgical populations, preoperative frailty assessment consistently predicts postoperative outcomes in non-cardiac surgeries.
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Becerra et al. (2024) conducted a systematic review in Non-cardiac surgery (n=145). Preoperative frailty was evaluated on Postoperative complications, mortality, and hospital stay. In a systematic review of 145 studies, preoperative frailty assessment consistently predicted postoperative complications, mortality, and hospital stay across non-cardiac surgical disciplines.
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