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2024 ; 16
(7
): 2319-2328
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Impact of frailty on postoperative outcomes after hepatectomy: A systematic
review and meta-analysis
#MMPMID39087100
Lv YJ
; Xu GX
; Lan JR
World J Gastrointest Surg
2024[Jul]; 16
(7
): 2319-2328
PMID39087100
show ga
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 random-effects 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.