Evidence map›Paper›PMID 33423069›Full record

SynthesisEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2022

Association between mortality and frailty in emergency general surgery: a systematic review and meta-analysis.

Christophe Alain Fehlmann, Dilan Patel, Jessica McCallum, Jeffrey Joseph Perry, Debra Eagles

Open access · hybridAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
20citing papers in PubMed, 4 pooled it
2.4field-weighted citation impact, top 12% 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

20 citing papers in PubMed, 4 syntheses or guidelines pooled it, 38 citations in OpenAlex.

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  17. Short and long-term impact of sarcopenia on outcomes from emergency laparotomy.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2022
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 2 institutions in 3 countries.

Christophe Alain FehlmannSchool of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, K1G 5Z3, Canada. christophe.fehlmann@hcuge.ch.ORCID http://orcid.org/0000-0002-4163-0338
Dilan PatelSchool of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, K1G 5Z3, Canada.
Jessica McCallumSchool of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, K1G 5Z3, Canada.
Jeffrey Joseph PerrySchool of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, K1G 5Z3, Canada.
Debra EaglesSchool of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, K1G 5Z3, Canada.
University of Ottawa · CAUniversity of Geneva · CH

Funding

Geneva University Hospital Geneva University Hospital Fellowship Program
6 · The paper itself

Abstract

purposeThe purpose of this review was to determine the association between frailty and mortality among adults ≥ 65 years old undergoing emergency general surgery (EGS).

methodsThis systematic review followed the PRISMA guidelines (CRD42020172482 on PROSPERO). A search in MEDLINE, PubMed, EMBASE, Scopus, Web of Science, and the Cochrane Database of Systematic Reviews was conducted from inception to March 5, 2020. Studies with patients ≥ 65 years undergoing EGS were included. The primary exposure was frailty, measured using the Clinical Frailty Scale or the Modified Frailty Index. The primary outcome was 30-day mortality. Secondary outcomes were 90-day and 1-year mortality, length of stay, complications, change in level of care at discharge, and loss of independence. Two independent reviewers screened articles and extracted data. Risk of bias was assessed according to the Newcastle-Ottawa Scale and quality of evidence was assessed using the GRADE approach. A meta-analysis was performed for 30-day mortality using a random-effects model.

resultsOur search yielded 847 articles and six cohort studies were included in the systematic review. There were 1289 patients, 283 being frail. The pooled OR from meta-analysis for frail compared to non-frail patients was 2.91 (95% CI 2.00, 4.23) for 30-day mortality. Frailty was associated with increased odds of all secondary outcomes.

conclusionFrailty is significantly associated with worse outcomes after emergency general surgery in adults ≥ 65 years of age. The Clinical Frailty Scale could be used to improve preoperative risk assessment for patients and shared decision-making between patients and healthcare providers. REGISTRATION NUMBER: CRD42020172482 (PROSPERO).

Indexed as

FrailtyAdultAgedFrail ElderlyHumansPatient DischargeRisk AssessmentClinical frailty scaleEmergency general surgeryFrailtySystematic review

Identifiers

PMID33423069
PMCPMC8825621
OpenAlexW3119184073

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.