SynthesisPloS one2017
Interventions to improve the outcomes of frail people having surgery: A systematic review.
Synthesis in PloS one, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 40 papers, 4 of them syntheses that pooled 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.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
40 citing papers in PubMed, 4 syntheses or guidelines pooled it, 114 citations in OpenAlex.
- The influence of frailty on outcomes of adult spinal deformity surgery: A systematic review and meta-analysis.Neurosurgical review · 2025Pooled it
- Multicomponent perioperative interventions to improve outcomes for frail patients: a systematic review.BMC geriatrics · 2024Pooled it
- Impact of preoperative uni- or multimodal prehabilitation on postoperative morbidity: meta-analysis.BJS open · 2023Pooled it
- Predictors of adherence to prescribed exercise programs for older adults with medical or surgical indications for exercise: a systematic review.Systematic reviews · 2022Pooled it
- Routine anaesthesia ward-based patient visits in surgery: 1-year outcomes of the TRACE randomized clinical trial.The British journal of surgery · 2025Trial
- Barriers and facilitators to participation in exercise prehabilitation before cancer surgery for older adults with frailty: a qualitative study.BMC geriatrics · 2023Trial
- Trial
- Brief Report: Disparities in PrEP Use Among HIV-Negative Black and Latina Women of Transgender Experience and Transfeminine People in Los Angeles County from 2019 to 2020 to 2023-2024.AIDS and behavior · 2026Article
- Association between preoperative frailty and 30-day functional disability after surgery: a prospective cohort study using the Edmonton Frail Scale.BMC anesthesiology · 2026Article
- Article
- Impact of a minimally invasive approach for colon cancer surgery on outcomes in patients with functional limitations.Colorectal cancer · 2025Article
- Frailty Status, Not Just Age, is Associated With Postoperative Opioid Consumption: A Retrospective, Population-based Analysis.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2024Article
- Risk model for morbidity and mortality following liver surgery based on a national Japanese database.Annals of gastroenterological surgery · 2024Article
- Frailty is not an independent risk factor for worse clinical outcomes in lumbar spinal surgery: a prospective cohort study.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2024Article
- Association of risk analysis index with 90-day failure to rescue following major abdominal surgery in geriatric patients.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2024Article
- A new risk calculation model for complications of hepatectomy in adults over 75.Perioperative medicine (London, England) · 2024Article
- Effect of prehabilitation exercises on postoperative frailty in patients undergoing laparoscopic colorectal cancer surgery.Frontiers in oncology · 2024Article
- Use of Artificial Intelligence in the Identification and Management of Frailty: A Scoping Review Protocol.BMJ open · 2023Article
- Efficacy of a modified FRAIL scale in predicting the peri-operative outcome of hepatectomy in older adults (aged ≥ 75 years): a model development study.BMC geriatrics · 2023Article
- A 5-year characterization of trends and outcomes in elderly patients undergoing elective bariatric surgery.Surgical endoscopy · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundFrailty is an important prognostic factor for adverse outcomes and increased resource use in the growing population of older surgical patients. We identified and appraised studies that tested interventions in populations of frail surgical patients to improve perioperative outcomes.
methodsWe systematically searched Cochrane, CINAHL, EMBASE and Medline to identify studies that tested interventions in populations of frail patients having surgery. All phases of study selection, data extraction, and risk of bias assessment were done in duplicate. Results were synthesized qualitatively per a prespecified protocol (CRD42016039909).
resultsWe identified 2 593 titles; 11 were included for final analysis, representing 1 668 participants in orthopedic, general, cardiac, and mixed surgical populations. Only one study was multicenter and risk of bias was moderate to high in all studies. Interventions were applied pre- and postoperatively, and included exercise therapy (n = 4), multicomponent geriatric care protocols (n = 5), and blood transfusion triggers (n = 1); no specific surgical techniques were compared. Exercise therapy, applied pre-, or post-operatively, was associated with significant improvements in functional outcomes and improved quality of life. Multicomponent protocols suffered from poor compliance and difficulties in implementation. Transfusion triggers had no significant impact on mortality or other outcomes.
conclusionsDespite a growing literature that demonstrates strong independent associations between frailty and adverse outcomes, few interventions have been tested to improve the outcomes of frail surgical patients, and most available studies are at substantial risk of bias. Multicenter, low risk of bias, studies of perioperative exercise are needed, while substantial efforts are required to develop and test other interventions to improve the outcomes of frail people having surgery.
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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.