SynthesisBMC geriatrics2022
The association between frailty and mortality among lower limb arthroplasty patients: a systematic review and meta-analysis.
Synthesis in BMC geriatrics, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it, 18 citations in OpenAlex.
- Association Between Frailty and Mortality, Falls and Hospitalisation Among Patients Undergoing Dialysis: A Systematic Review and Meta-Analysis.Nursing open · 2025Pooled it
- Predicting 5-Year Mortality After Prosthetic Joint Infection Using a 30-Item Accumulated Frailty Index in a 13,371-Patient Multicenter Cohort.Arthroplasty today · 2026Article
- Can frailty predict complications and mortality in patients undergoing total knee arthroplasty? A systematic review and meta-analysis.Pakistan journal of medical sciences · 2026Article
- Efficacy and safety of intrathecal adjuvants in lower limb orthopaedic surgery: a systematic review and network meta-analysis of randomised controlled trials.Journal of anesthesia, analgesia and critical care · 2026Review
- Impact of preoperative education on early outcomes following hip and knee arthroplasty : a 21,000-patient multicentre NHS analysis.Bone & joint open · 2026Article
- The Influence of Frailty on Total Hip Arthroplasty Outcomes: A Propensity-Matched Study of 90,660 Patients Using the Modified Frailty Index.Journal of clinical medicine · 2026Article
- Upper extremity fractures and subsequent total knee arthroplasty incidence in knee osteoarthritis: a cross-continental propensity score-matched cohort study.Journal of orthopaedic surgery and research · 2026Article
- Frailty across Hip arthroplasty pathways: vulnerability domains, outcomes, and implications for care-a narrative review.Frontiers in surgery · 2026Review
- Moving from just measuring, to acting on frailty in specialties outside geriatrics.European geriatric medicine · 2025Article
- Angiotensin II receptor blockers and their applications in orthopaedic surgery and musculoskeletal medicine.Annals of joint · 2024Review
- The Role of Surgical Prehabilitation During the COVID-19 Pandemic and Beyond.Physical medicine and rehabilitation clinics of North America · 2023Review
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSome studies associate frailty and postoperative mortality in hip or knee replacement patients, and others have explored the relationship between the frailty index and changes in postoperative mortality in hip or knee replacement patients, but their findings are not consistent. This meta-analysis and systematic review aimed to pool the results of existing studies to explore whether frailty is an independent risk factor for postoperative mortality in patients with lower limb arthroplasty (including hip or knee arthroplasty).
methodsOn December 15, 2021, we searched the relevant articles from the PubMed, Embase, Medline (via Ovid), China National Knowledge Infrastructure (CNKI) and Wan Fang Med Online databases. We used the Newcastle-Ottawa Scale (NOS) to assess the quality of the articles that met the exclusion and inclusion criteria. R Studio was used to analyze the effect sizes (based on the random model integration) on the extracted data. Meanwhile, potential publication bias and sensibility analysis were performed.
resultsWe included seven studies, which included a total of 460,594 patients, for quantitative analysis. Overall, frailty increased the risk of mortality in lower limb arthroplasty patients compared to those without frailty, as measured by a pooled risk ratio (RR) of 2.46 (95% confidence interval [CI]: 1.81-3.33). Additionally, subgroup analysis based on population revealed that the pooled RRs for total knee arthroplasty (TKA) patients in three studies and total hip arthroplasty (THA) patients in four studies were 2.61 (95% CI: 2.26-3.02) and 3.18 (95% CI: 1.92-5.28), respectively, for TKA patients in three studies and THA patients in four studies. Additionally, these statistically significant positive associations persisted in subgroup analyses by study design, geographic region, and follow-up period.
conclusionFrailty is an independent risk factor for postoperative mortality in patients undergoing lower limb arthroplasty, according to our findings. This suggests that frailty may be a predictor of preoperative risk stratification for patients with such elective surgery and could alert doctors and nurses of early screening and medical care interventions in patients with such a need for surgery to reduce postoperative mortality in lower limb arthroplasty patients.
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Registered trials
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