Key result
Frailty in patients undergoing abdominal aortic aneurysm surgery was associated with increased short-term all-cause mortality compared to non-frail individuals (RR 3.20; 95% CI 1.95-5.26).
Why the study?
The prognostic role of frailty in patients with abdominal aortic aneurysm undergoing surgery was not well defined.
Does frailty increase the risk of mortality and complications in patients with abdominal aortic aneurysm undergoing surgery?
Meta-Analysis (n=323,788)
Does frailty increase the risk of mortality and complications in patients with abdominal aortic aneurysm undergoing surgery?
Relative Risk: 3.2 (95% CI 1.95–5.26)
Frailty is a strong independent predictor of short- and long-term mortality and postoperative complications in patients undergoing surgery for abdominal aortic aneurysm.
Frailty assessment may refine postoperative risk stratification in AAA; leaves open whether targeted interventions improve outcomes.
OBJECTIVE: To explore the prognostic role of frailty in patients with abdominal aortic aneurysm (AAA) by conducting this systematic review and meta-analysis METHODS: We conducted an extensive literature search on PubMed, Web of Sciences, and Embase databases to identify studies that reported the association of frailty with postoperative complications, reintervention, or all-cause mortality in patients with AAA after surgery. Short-term mortality was defined by a combination of in-hospital and 30-day death. RESULTS: Seven cohort studies reporting on 9 articles with 323,788 AAA patients were included. The reported prevalence of frailty in AAA patients ranged between 2.3% and 34.6%. Pooling the results revealed that frailty was significantly associated with a higher risk of short-term all-cause mortality (adjusted risk ratios [RR] 3.20; 95% confidence intervals [CI] 1.95-5.26), long-term all-cause mortality (adjusted RR 2.86; 95% CI 2.57-3.17), and postoperative complications (adjusted RR 2.19; 95% CI 1.50-3.20) compared to non-frail individuals. However, there was no clear association between frailty and reintervention (HR 1.44; 95% CI 0.97-2.16). CONCLUSIONS: Frailty independently predicts the short and long-term survival as well as postoperative complications in patients with AAA undergoing surgery. Assessing frail status may potentially enhance surgical decision-making for these patients.
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Zhang et al. (2024) conducted a meta-analysis in abdominal aortic aneurysm (AAA) (n=323,788). Frailty vs. non-frail individuals was evaluated on short-term all-cause mortality (RR 3.20, 95% CI 1.95-5.26). Frailty in patients undergoing abdominal aortic aneurysm surgery was associated with increased short-term all-cause mortality compared to non-frail individuals (RR 3.20; 95% CI 1.95-5.26).
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