Evidence map›Paper›PMID 27580947›Full record

SynthesisBMC geriatrics2016

Frailty and post-operative outcomes in older surgical patients: a systematic review.

Hui-Shan Lin, J N Watts, N M Peel, R E Hubbard

6 registry-linked trialsOpen access · goldAbstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMC geriatrics, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 6 registered trials, which are not on this map. Cited by 456 papers, 13 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
456citing papers in PubMed, 13 pooled it
34.2field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04056871 completednot on this mapstarted 2019, after this paper: background citation

Comparing the Association of Different Frailty Scores to the Incidence of Post-operative Delirium and Cognitive Dysfunction

TypeobservationalSponsorUniversity of MalayaRan2019 to 2020Enrolled400ConditionsFrail Elderly Syndrome, Postoperative Delirium, Postoperative Cognitive DysfunctionArmsFrailty Screening Tools
NCT04715581 narecruitingnot on this mapstarted 2021, after this paper: background citation

Effect of Multicomponent Prehabilitation on Early and Long-term Outcomes in Elderly Patients With Frailty After Digestive Surgery for Cancer: A Randomized-controlled Study

TypeinterventionalSponsorPeking University First HospitalRan2021 to 2028Enrolled540ConditionsOld Age, Debility, Digestive Cancer, SurgeryArmsPreoperative nutritional optimization, Preoperative exercise training, Postoperative exercise training
NCT04717869 recruitingnot on this mapstarted 2023, after this paper: background citation

Identifying Modifiable PAtient Centered Therapeutics Frailty: An Observational Cohort Study

TypeobservationalSponsorUniversity of California, Los AngelesRan2023 to 2026Enrolled250ConditionsFrailty, SarcopeniaArmsUltrasound, Biomarker Analysis, Frailty Index
NCT04729738 completednot on this map

The Impact of Comorbidities, Frailty Malnutrition and Sarcopenia on Short-term Mortality in Patients Undergoing Laparoscopic Colon Surgery

TypeobservationalSponsorUniversity Hospital of FerraraRan2012 to 2020Enrolled420ConditionsColon Cancer, Malnutrition, Sarcopenia, Comorbidities and Coexisting Conditions
NCT05968456 unknown statusnot on this mapstarted 2023, after this paper: background citation

Complexity and Frailty in Cardiothoracic and Vascular Anesthesia (CAfCA). Prospective Multicentric Observational Study

TypeobservationalSponsorIstituto Clinico HumanitasRan2023 to 2024Enrolled500ConditionsFrailty, Anesthesia, Thoracic Surgery, Cardiothoracic SurgeryArmsData collection
NCT07027241 nanot yet recruitingnot on this mapstarted 2025, after this paper: background citation

Multicomponent Exercise and Nutrition Based Frailty Intervention in Postoperative Hip Fracture Inpatients

TypeinterventionalSponsorRoyal College of Surgeons, IrelandRan2025 to 2026Enrolled50ConditionsHip Fractures (ICD-10 72.01-72.2), Frailty at Older Adults, Strength Training, Resistance TrainingArmsExercise Intervention, Usual Care, Nutritional Intervention
3 · Its place in the literature

Who cites it

456 citing papers in PubMed, 13 syntheses or guidelines pooled it, 1,079 citations in OpenAlex.

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396 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

4 authors at 1 institution in 1 country.

Hui-Shan LinCentre for Research in Geriatric Medicine, Princess Alexandra Hospital, The University of Queensland, Level 2, Building 33, Ipswich Road, Woolloongabba, QLD, 4102, Australia. huishan.lin@uq.net.au.ORCID 0000-0003-4863-6174
J N WattsCentre for Research in Geriatric Medicine, Princess Alexandra Hospital, The University of Queensland, Level 2, Building 33, Ipswich Road, Woolloongabba, QLD, 4102, Australia.
N M PeelCentre for Research in Geriatric Medicine, Princess Alexandra Hospital, The University of Queensland, Level 2, Building 33, Ipswich Road, Woolloongabba, QLD, 4102, Australia.
R E HubbardCentre for Research in Geriatric Medicine, Princess Alexandra Hospital, The University of Queensland, Level 2, Building 33, Ipswich Road, Woolloongabba, QLD, 4102, Australia.
The University of Queensland · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAs the population ages, increasing numbers of older adults are undergoing surgery. Frailty is prevalent in older adults and may be a better predictor of post-operative morbidity and mortality than chronological age. The aim of this review was to examine the impact of frailty on adverse outcomes in the 'older old' and 'oldest old' surgical patients.

methodsA systematic review was undertaken. Electronic databases from 2010 to 2015 were searched to identify articles which evaluated the relationship between frailty and post-operative outcomes in surgical populations with a mean age of 75 and older. Articles were excluded if they were in non-English languages or if frailty was measured using a single marker only. Demographic data, type of surgery performed, frailty measure and impact of frailty on adverse outcomes were extracted from the selected studies. Quality of the studies and risk of bias was assessed by the Epidemiological Appraisal Instrument.

resultsTwenty-three studies were selected for the review and they were assessed as medium to high quality. The mean age ranged from 75 to 87 years, and included patients undergoing cardiac, oncological, general, vascular and hip fracture surgeries. There were 21 different instruments used to measure frailty. Regardless of how frailty was measured, the strongest evidence in terms of numbers of studies, consistency of results and study quality was for associations between frailty and increased mortality at 30 days, 90 days and one year follow-up, post-operative complications and length of stay. A small number of studies reported on discharge to institutional care, functional decline and lower quality of life after surgery, and also found a significant association with frailty.

conclusionThere was strong evidence that frailty in older-old and oldest-old surgical patients predicts post-operative mortality, complications, and prolonged length of stay. Frailty assessment may be a valuable tool in peri-operative assessment. It is possible that different frailty tools are best suited for different acuity and type of surgical patients. The association between frailty and return to pre-morbid function, discharge destination, and quality of life after surgery warrants further research.

Indexed as

Postoperative ComplicationsQuality of LifeSurgical Procedures, OperativeActivities of Daily LivingAgedAged, 80 and overFrail ElderlyGeriatric AssessmentHumansInstitutionalizationFrailtyGeriatricMortalityOldest oldPost-operative complications

Identifiers

PMID27580947
PMCPMC5007853
OpenAlexW2507525628

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.