Evidence map›Paper›PMID 40519493›Full record

ReviewCureus2025

Frailty Status as a Predictor of Outcomes in Emergency Surgeries for Older Adults: A Systematic Review and Meta-Analysis.

Svetlana Doris Brincat, Clifford Caruana, Rajarshi Mukherjee

Abstract readReview
In one paragraph

Review in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing 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

3 citing papers in PubMed.

  1. Article
  2. A multidimensional approach to frailty in emergency surgery for perforated peptic ulcer.Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES · 2026
    Article
  3. 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

3 authors.

Svetlana Doris BrincatDepartment of Surgery, Mater Dei Hospital, Msida, MLT.
Clifford CaruanaDepartment of Surgery, Mater Dei Hospital, Msida, MLT.
Rajarshi MukherjeeDepartment of Emergency General and Major Trauma Surgery, Aintree University Hospital, Liverpool, GBR.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The global aging population has brought increasing attention to frailty as a critical predictor of health outcomes. Defined by the British Geriatric Society as a state of diminished physiological reserve across multiple systems, frailty reflects a heightened vulnerability to adverse events. While the negative impact of frailty is well established in elective surgical settings, its influence on outcomes following emergency abdominal surgery remains less clear. This meta-analysis evaluates postoperative outcomes in frail versus non-frail elderly patients undergoing emergency abdominal surgery. A comprehensive search of eight electronic databases was conducted from inception to January 2024, with an additional search in June 2024. Eligible studies were selected based on predefined inclusion criteria. The primary outcome was postoperative mortality, with secondary outcomes, including complications, length of hospital stay, discharge destination, readmission, and reoperation rates. Data were synthesized using RevMan5 (Cochrane Collaboration, London, UK) and R (R Development Core Team, Vienna, Austria), applying both fixed and random-effects models. Risk of bias in individual studies was assessed using the Quality in Prognostic Studies (QUIPS) tool. Thirty-one studies involving 1,750,195 participants were included. Frail patients showed significantly increased 30-day (OR: 2.83, 95% CI: 2.45-3.27; p<0.00001) and 12-month (OR: 1.97, 95% CI: 1.32-2.93; p=0.0008) mortality. They also experienced higher overall morbidity, more severe complications (Clavien-Dindo ≥3: OR: 2.39, 95% CI: 1.82-3.13; p<0.00001), longer hospital stays (WMD: 3.74 days, 95% CI: 1.54-5.94; p=0.0008), and increased rates of readmission and reoperation (OR: 1.48, 95% CI: 1.25-1.75; p<0.00001). Discharge to rehabilitation or skilled nursing facilities was also more common among frail patients. These findings demonstrate that frailty significantly worsens postoperative outcomes in elderly patients undergoing emergency abdominal surgery. Further research is warranted to explore the integration of frailty assessment tools in emergency settings to support surgical decision-making for this vulnerable population.

Indexed as

acute abdominal surgerycomplicationselderly patientsemergency surgeryfrailtymortality

Identifiers

PMID40519493
PMCPMC12166765

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.