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January 9, 2021European Journal of Trauma and Emergency SurgeryOpen Access

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

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Key result

Frailty was associated with a nearly threefold increased odds of 30-day mortality (OR 2.91) compared to non-frail patients among adults aged 65 years and older undergoing emergency general surgery.

Why the study?

The study was conducted to determine the association between frailty and mortality among adults ≥ 65 years old undergoing emergency general surgery.

Does frailty increase mortality in adults ≥ 65 years old undergoing emergency general surgery?

Population

1289 adults ≥ 65 years old undergoing emergency general surgery across six cohort studies

Comparison

Frail vs non-frail patients

Design

Systematic review and random-effects meta-analysis

Authors

CFChristophe A. FehlmannDPDilan PatelJMJessica McCallum

Discussion

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Overview

Frailty screening may aid risk stratification in older EGS patients; leaves open whether interventions improve outcomes.

Study Design

Type

Meta-Analysis (n=1,289)

Structured PICO

Does frailty increase mortality in adults ≥ 65 years old undergoing emergency general surgery?

P
Population
1,289 adults aged 65 years and older undergoing emergency general surgery, of whom 283 were frail, included in a meta-analysis of six cohort studies to assess 30-day mortality.
E
Exposure
Frailty (measured using the Clinical Frailty Scale or the Modified Frailty Index)
C
Comparator
Non-frail patients
O
Outcome
30-day mortalityhard clinical

Main Result

Odds Ratio: 2.91 (95% CI 2–4.23)

Frailty is significantly associated with increased 30-day mortality and worse secondary outcomes in older adults undergoing emergency general surgery.

Limitations

  • Only included studies that reported frailty measured by the Clinical Frailty Scale or the Modified Frailty Index.
  • Many studies were excluded because emergency general surgery patients were mixed with younger patients or non-emergency surgeries.
  • The meta-analysis was based on unadjusted estimates, which could be biased due to confounding.
  • Only one study met eligibility criteria using the Modified Frailty Index.

Cite This Study

Fehlmann et al. (2021) conducted a meta-analysis in Emergency general surgery (n=1,289). Frailty vs. Non-frail was evaluated on 30-day mortality (OR 2.91, 95% CI 2.00-4.23). Frailty was associated with a nearly threefold increased odds of 30-day mortality (OR 2.91) compared to non-frail patients among adults aged 65 years and older undergoing emergency general surgery.

synapsesocial.com/papers/6a7bb7a3c2a640f0bcdf7e39https://doi.org/10.1007/s00068-020-01578-9
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