Impact of frailty on postoperative outcomes after hepatectomy:A systematic review and meta-analysis  

作　　者：Yao-Jia Lv Guang-Xing Xu Jia-Rong Lan 

机构地区：[1]Day Surgery Ward,Huzhou Central Hospital,The Affiliated Central Hospital of Huzhou University,Huzhou 313000,Zhejiang Province,China [2]School of Basic Medical Sciences,Zhejiang Chinese Medical University,Hangzhou 310053,Zhejiang Province,China [3]Department of Medicine,Huzhou Traditional Chinese Medicine Hospital Affiliated to Zhejiang Chinese Medical University,Huzhou 313000,Zhejiang Province,China

出　　处：《World Journal of Gastrointestinal Surgery》2024年第7期2319-2328,共10页世界胃肠外科杂志（英文版）（电子版）

摘　　要：BACKGROUND The impact of frailty on postoperative outcomes in patients undergoing hepatectomy is still unclear.AIM To study the influence of frailty on postoperative outcomes,such as mortality,rate of complications,and length of hospitalization,following hepatectomy.METHODS PubMed,EMBASE,and Scopus databases were searched for observational studies with adult(≥18 years)patients after planned/elective hepatectomy.A randomeffects model was used for all analyses,and the results are expressed as weighted mean difference(WMD),relative risk(RR),or hazards ratio(HR)with 95%confidence interval(CI).RESULTS Analysis of the 13 included studies showed a significant association of frailty with elevated risk of in-hospital mortality(RR=2.76,95%CI:2.10-3.64),mortality at 30 d(RR=4.60,95%CI:1.85-11.40),and mortality at 90 d(RR=2.52,95%CI:1.70-3.75)in the postoperative period.Frail patients had a poorer long-term survival(HR=2.89,95%CI:1.84-4.53)and higher incidence of“any”complications(RR=1.69,95%CI:1.40-2.03)and major(grade III or higher on the Clavien-Dindo scale)complications(RR=2.69,95%CI:1.85-3.92).Frailty was correlated with markedly lengthier hospital stay(WMD=3.65,95%CI:1.45-5.85).CONCLUSION Frailty correlates with elevated risks of mortality,complications,and prolonged hospitalization,which need to be considered in surgical management.Further research is essential to formulate strategies for improved outcomes in this vulnerable cohort.

关 键 词：FRAILTY Frail adults Hepatic resection HEPATECTOMY COMPLICATIONS Mortality Survival Clinical outcomes META-ANALYSIS 

分 类 号：R657.3[医药卫生—外科学]