AUTHOR=Chen Shujie , Dunn Riley , Jackson Mark , Morley Nicola , Sun Jing 

TITLE=Frailty score and outcomes of patients undergoing vascular surgery and amputation: A systematic review and meta-analysis

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=Volume 10 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2023.1065779

DOI=10.3389/fcvm.2023.1065779

ISSN=2297-055X

ABSTRACT=Introduction
Frailty is associated with adverse postoperative health outcomes, including increased
mortality, longer length of stay, higher rehospitalization, and comorbidities. Many frailty
assessment tools are to assess the level of frailty in vascular surgery patients. The aim of this
study was to use a systematic review and meta-analysis to assess the association between the
frailty levels described by different frailty scores and adverse postoperative health outcomes
among hospitalized vascular surgery patients and patients who have undergone amputations
only.
Methods
Studies utilizing frailty scores and similar frailty assessment tools to describe frailty and
investigate the association between frailty and health outcomes were searched. The primary
outcomes of this study were in-hospital mortality, post discharge mortality, length of hospital
stay, rehospitalization, and discharge location. Additional outcomes included postoperative
myocardial infarction, postoperative renal failure, cerebrovascular accident and stroke,
comorbidities, and estimated glomerular filtration rate (eGFR) levels. Joanna Briggs Institute
(JBI) Critical Appraisal Tools were used for quality assessment.
Results
In total, 24 studies with 1,886,611 participants were included in the final analysis. The overall
results found that higher in-hospital mortality and post discharge mortality were significantly
associated with frailty. Frailty was also found to be significantly associated with a longer
length of hospital stay, higher rehospitalization, and higher likelihood of non-home discharge.
In addition, the results also showed that frailty was significantly associated with all kinds of
comorbidities investigated, except chronic kidney disease. However, lower eGFR levels were
significantly associated with frailty.
Conclusion
Among patients who underwent all types of vascular surgeries and those who underwent
amputations, being frail was significantly associated with adverse postoperative outcomes
and multiple comorbidities.