Evidence map›Paper›PMID 32778405›Full record

ArticleBritish journal of anaesthesia2020

Frailty and long-term postoperative disability trajectories: a prospective multicentre cohort study.

Daniel I McIsaac, Monica Taljaard, Gregory L Bryson, Paul E Beaulé, Sylvain Gagne, Gavin Hamilton, Emily Hladkowicz, Allen Huang, John Joanisse, Luke T Lavallée and 6 more

Open access · bronzeAbstract readMulticenter Study
PubMed Publisher
In one paragraph

Article in British journal of anaesthesia, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 36 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
36citing papers in PubMed, 1 pooled it
4.1field-weighted citation impact, top 5% 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

36 citing papers in PubMed, 1 synthesis or guideline pooled it, 67 citations in OpenAlex.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

16 authors at 5 institutions in 1 country.

Daniel I McIsaacDepartment of Anesthesiology and Pain Medicine, University of Ottawa, Ottawa, ON, Canada; Clinical Epidemiology Program, The Ottawa Hospital Research Institute, Ottawa, ON, Canada; Department of Anesthesiology, The Ottawa Hospital, Ottawa, ON, Canada; School of Epidemiology and Public Health, University of Ottawa, ON, Canada. Electronic address: dmcisaac@toh.ca.
Monica TaljaardClinical Epidemiology Program, The Ottawa Hospital Research Institute, Ottawa, ON, Canada; School of Epidemiology and Public Health, University of Ottawa, ON, Canada.
Gregory L BrysonDepartment of Anesthesiology and Pain Medicine, University of Ottawa, Ottawa, ON, Canada; Clinical Epidemiology Program, The Ottawa Hospital Research Institute, Ottawa, ON, Canada; Department of Anesthesiology, The Ottawa Hospital, Ottawa, ON, Canada.
Paul E BeauléDepartment of Surgery, Division of Orthopedic Surgery, University of Ottawa, Ottawa, ON, Canada.
Sylvain GagneDepartment of Anesthesiology and Pain Medicine, University of Ottawa, Ottawa, ON, Canada.
Gavin HamiltonDepartment of Anesthesiology and Pain Medicine, University of Ottawa, Ottawa, ON, Canada.
Emily HladkowiczDepartment of Anesthesiology and Pain Medicine, The Ottawa Hospital Research Institute, Ottawa, ON, Canada.
Allen HuangClinical Epidemiology Program, The Ottawa Hospital Research Institute, Ottawa, ON, Canada; Department of Medicine, Division of Geriatric Medicine, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada.
John JoanisseDepartment of Family Medicine, Hôpital Montfort, Ottawa, ON, Canada.
Luke T LavalléeClinical Epidemiology Program, The Ottawa Hospital Research Institute, Ottawa, ON, Canada; Department of Surgery, Division of Urology, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada.
David MacDonaldDepartment of Anesthesia, Pain Management, and Perioperative Medicine, Dalhousie University, Halifax, NS, Canada.
Husein MolooClinical Epidemiology Program, The Ottawa Hospital Research Institute, Ottawa, ON, Canada; Department of Surgery, Division of General Surgery, University of Ottawa, Ottawa, ON, Canada.
Kednapa ThavornClinical Epidemiology Program, The Ottawa Hospital Research Institute, Ottawa, ON, Canada; School of Epidemiology and Public Health, University of Ottawa, ON, Canada.
Carl van WalravenClinical Epidemiology Program, The Ottawa Hospital Research Institute, Ottawa, ON, Canada; Department of Medicine, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada.
Homer YangDepartment of Anesthesia & Perioperative Medicine, Schulich School of Medicine, London, ON, Canada.
Alan J ForsterClinical Epidemiology Program, The Ottawa Hospital Research Institute, Ottawa, ON, Canada; Department of Medicine, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada.
University of Ottawa · CADalhousie University · CAMontfort Hospital · CAOttawa Hospital · CAWestern University · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundFrailty is associated with early postoperative outcomes. How frailty influences long-term postoperative recovery is poorly described. Our objective was to evaluate the association of frailty with postoperative disability trajectories in the year after surgery.

methodsPrespecified 1-yr follow-up of a prospective multicentre cohort study. Patients ≥65 yr were assessed for frailty before major elective noncardiac surgery (Clinical Frailty Scale [CFS] and Fried Phenotype [FP]). The primary outcome was patient-reported disability score (using the WHO Disability Assessment Schedule 2.0) at baseline, 30, 90, and 365 days after surgery. Repeated measures linear regression estimated the association of preoperative frailty with changes in disability scores over time, adjusted for procedure. Group-based trajectory modelling was used to identify subgroup trajectories of people with frailty.

resultsOne-year follow-up was complete for 687/702 (97.9%) participants. Frailty was associated with a significant difference in disability trajectory (P<0.0001). Compared with baseline, people with frailty experienced a decrease in disability score at 365 days (CFS frailty: -7.3 points, 95% confidence interval [CI] -10.2 to -4.5); (FP frailty: -5.4 points, 95% CI -8.5 to -2.3); people without frailty had no significant change in their disability score from baseline (no CFS frailty: +0.8 points, 95% CI -1.7 to 3.2; no FP frailty: +1.1 points, 95% CI -3.5 to 1.3). More than one-third of people with frailty experienced an early increase in disability before achieving a net decrease in disability.

conclusionsDecision-making and care planning should integrate the possible trade-offs between early adverse outcomes with longer-term benefit when frailty is present in older surgical patients.

Indexed as

Disability EvaluationFrailtyAgedAged, 80 and overCohort StudiesFemaleFollow-Up StudiesFrail ElderlyGeriatric AssessmentHumansMalePostoperative ComplicationsProspective StudiesRecovery of FunctionRisk FactorsTreatment Outcomedisabilityepidemiologyfrailtypostoperative outcomerecoverysurgery

Identifiers

PMID32778405
OpenAlexW3047968161

What OpenQuestion holds

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Registered trials

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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.