ReviewAging and disease2020
Influence of Frailty on Outcome in Older Patients Undergoing Non-Cardiac Surgery - A Systematic Review and Meta-Analysis.
Review in Aging and disease, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 42 papers, 3 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
42 citing papers in PubMed, 3 syntheses or guidelines pooled it, 70 citations in OpenAlex.
- Prevalence and risk factors of frailty among cardiac surgery patients: a systematic review and meta-analysis.Annals of medicine · 2025Pooled it
- Association between frailty and postoperative delirium: a meta-analysis of cohort study.Aging clinical and experimental research · 2022Pooled it
- The Impact of Frailty on Adverse Outcomes in Geriatric Hip Fracture Patients: A Systematic Review and Meta-Analysis.Frontiers in public health · 2022Pooled it
- Opioid-Free Anesthesia with Esketamine Combined with Iliac Fascia Block in Elderly Patients Undergoing Hip Surgery.Drug design, development and therapy · 2025Trial
- Trephine Stoma in High-Risk Patients: Feasibility and Short-Term Outcomes.Journal of clinical medicine · 2026Article
- Elective Lumbar Decompression With Fusion Is Associated With Increased Mortality Compared With Decompression Alone: A National Propensity-Matched Analysis of Aging Cohorts.Global spine journal · 2026Article
- Translation, Cross-Cultural Adaptation and Validation of the Serbian Version of the Clinical Frailty Scale in Patients Undergoing Major Uro-Oncological Surgery.Healthcare (Basel, Switzerland) · 2026Article
- Frailty Predicts Neurological Outcome in Chronic Subdural Hematoma: A Single-Center Prospective Cohort Study.Geriatrics (Basel, Switzerland) · 2026Article
- Analysis of Determinants and Development of a Predictive Model for Postoperative Cognitive Dysfunction in Patients Undergoing Hepatectomy.Journal of clinical medicine · 2026Article
- Frailty assessment and candidate optimization before cardiothoracic transplantation.JHLT open · 2026Article
- Hepatectomy for Hepatocellular Carcinoma in Elderly Patients: Perioperative Outcomes in the Modern Minimally Invasive Era.Journal of clinical medicine · 2026Article
- How does Frailty Impact Peri-Operative and Speech Recognition Outcomes for Cochlear Implants in Veterans?Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery · 2026Article
- Integration of MSK-FI and clinical variables to predict postoperative complications after esophagectomy.Journal of thoracic disease · 2026Article
- Preoperative Cognitive Function and Physical Frailty Predict Decision Satisfaction and Postoperative Adherence in Older Gynecologic Oncology Patients: A Prospective Observational Study.Current oncology (Toronto, Ont.) · 2026Observational
- Predictive Performance of Frailty Indices for Complications and Functional Recovery After Distal Radius Fracture Surgery in Patients Aged ≥65 years.Geriatric orthopaedic surgery & rehabilitation · 2026Article
- A prediction model based on nutritional variables of postoperative pulmonary infection after colorectal cancer surgery.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2025Article
- Multicomponent prehabilitation and perioperative care in older persons with frailty referred to planned orthopaedic surgery: A feasibility study.Aging clinical and experimental research · 2025Article
- Enhancing postoperative recovery with multimodal prehabilitation: the journey begins before surgery.Korean journal of anesthesiology · 2025Review
- Critique on construction of a risk factor prediction model of postoperative complications of elderly patients with colorectal cancer using machine learning.Journal of robotic surgery · 2025Article
- Impact of preoperative frailty on outcomes in patients subjected to emergency laparotomy: a prospective study.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Frailty is increasingly recognized as a better predictor of adverse postoperative events than chronological age. The objective of this review was to systematically evaluate the effect of frailty on postoperative morbidity and mortality. Studies were included if patients underwent non-cardiac surgery and if frailty was measured by a validated instrument using physical, cognitive and functional domains. A systematic search was performed using EMBASE, MEDLINE, Web of Science, CENTRAL and PubMed from 1990 - 2017. Methodological quality was assessed using an assessment tool for prognosis studies. Outcomes were 30-day mortality and complications, one-year mortality, postoperative delirium and discharge location. Meta-analyses using random effect models were performed and presented as pooled risk ratios with confidence intervals and prediction intervals. We included 56 studies involving 1.106.653 patients. Eleven frailty assessment tools were used. Frailty increases risk of 30-day mortality (31 studies, 673.387 patients, risk ratio 3.71 [95% CI 2.89-4.77] (PI 1.38-9.97; I2=95%) and 30-day complications (37 studies, 627.991 patients, RR 2.39 [95% CI 2.02-2.83). Risk of 1-year mortality was threefold higher (six studies, 341.769 patients, RR 3.40 [95% CI 2.42-4.77]). Four studies (N=438) reported on postoperative delirium. Meta-analysis showed a significant increased risk (RR 2.13 [95% CI 1.23-3.67). Finally, frail patients had a higher risk of institutionalization (10 studies, RR 2.30 [95% CI 1.81- 2.92]). Frailty is strongly associated with risk of postoperative complications, delirium, institutionalization and mortality. Preoperative assessment of frailty can be used as a tool for patients and doctors to decide who benefits from surgery and who doesn't.
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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.