Evidence map›Paper›PMID 39166472›Full record

SynthesisBJS open2024

Frailty using the Clinical Frailty Scale to predict short- and long-term adverse outcomes following emergency laparotomy: meta-analysis.

Brittany Park, Zena Alani, Edrick Sulistio, Ahmed W H Barazanchi, Jonathan Koea, Alain Vandal, Andrew G Hill, Andrew D MacCormick

Abstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BJS open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed
–field-weighted citation impact
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

11 citing papers in PubMed.

  1. Article
  2. Article
  3. Review
  4. Article
  5. Article
  6. Article
  7. Article
  8. Article
  9. Article
  10. Review
  11. 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 · 2025
    Article
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

8 authors.

Brittany ParkDepartment of Surgery, The University of Auckland, Middlemore Hospital, Auckland, Aotearoa New Zealand.ORCID 0000-0002-7340-1046
Zena AlaniDepartment of Surgery, The University of Auckland, Middlemore Hospital, Auckland, Aotearoa New Zealand.
Edrick SulistioDepartment of Surgery, The University of Auckland, Middlemore Hospital, Auckland, Aotearoa New Zealand.
Ahmed W H BarazanchiDepartment of Surgery, The University of Auckland, Middlemore Hospital, Auckland, Aotearoa New Zealand.
Jonathan KoeaDepartment of Surgery, The University of Auckland, Middlemore Hospital, Auckland, Aotearoa New Zealand.
Alain VandalDepartment of Statistics, The University of Auckland, Auckland, Aotearoa New Zealand.
Andrew G HillDepartment of Surgery, The University of Auckland, Middlemore Hospital, Auckland, Aotearoa New Zealand.ORCID 0000-0001-8672-6379
Andrew D MacCormickDepartment of Surgery, The University of Auckland, Middlemore Hospital, Auckland, Aotearoa New Zealand.ORCID 0000-0002-6255-4792

Funding

Auckland Medical Research FoundationDouglas Goodfellow Medical Research Fellowship
6 · The paper itself

Abstract

backgroundEmergency laparotomy has high morbidity and mortality rates. Frailty assessment remains underutilized in this setting, in part due to time constraints and feasibility. The Clinical Frailty Scale has been identified as the most appropriate tool for frailty assessment in emergency laparotomy patients and is recommended for all older patients undergoing emergency laparotomy. The prognostic impact of measured frailty using the Clinical Frailty Scale on short- and long-term mortality and morbidity rates remains to be determined.

methodsObservational cohort studies were identified by systematically searching Medline, Embase, Scopus and CENTRAL databases up to February 2024, comparing outcomes following emergency laparotomy for frail and non-frail participants defined according to the Clinical Frailty Scale. The primary outcomes were short- and long-term mortality rates. A random-effects model was created with pooling of effect estimates and a separate narrative synthesis was created. Risk of bias was assessed.

resultsTwelve articles comprising 5704 patients were included. Frailty prevalence was 25% in all patients and 32% in older adults (age ≥55 years). Older patients with frailty had a significantly greater risk of postoperative death (30-day mortality rate OR 3.84, 95% c.i. 2.90 to 5.09, 1-year mortality rate OR 3.03, 95% c.i. 2.17 to 4.23). Meta-regression revealed that variations in cut-off values to define frailty did not significantly affect the association with frailty and 30-day mortality rate. Frailty was associated with higher rates of major complications (OR 1.93, 95% c.i. 1.27 to 2.93) and discharge to an increased level of care.

conclusionFrailty is significantly correlated with short- and long-term mortality rates following emergency laparotomy, as well as an adverse morbidity rate and functional outcomes. Identifying frailty using the Clinical Frailty Scale may aid in patient-centred decision-making and implementation of tailored care strategies for these 'high-risk' patients, with the aim of reducing adverse outcomes following emergency laparotomy.

Indexed as

FrailtyGeriatric AssessmentLaparotomyPostoperative ComplicationsAgedAged, 80 and overEmergenciesFrail ElderlyHumansObservational Studies as TopicPrognosis

Identifiers

PMID39166472
PMCPMC11336663

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.