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dc.contributor.authorHoughton, John
dc.contributor.authorNickinson, Andrew
dc.contributor.authorNduwayo, Sarah
dc.contributor.authorPepper, Coral
dc.contributor.authorRayt, Harjeet
dc.contributor.authorHaunton, Victoria
dc.contributor.authorSayers, Rob
dc.date.accessioned2021-11-30T15:19:11Z
dc.date.available2021-11-30T15:19:11Z
dc.identifier.citationHoughton, J., Nickinson, A., Morton, A. J., Nduwayo, S., Pepper, C. J., Rayt, H. S., Gray, L. J., Conroy, S. P., Haunton, V. J., & Sayers, R. D. (2020). Frailty Factors and Outcomes in Vascular Surgery Patients: A Systematic Review and Meta-analysis. Annals of surgery, 272(2), 266–276.en_US
dc.identifier.otherhttps://doi.org/10.1097/SLA.0000000000003642
dc.identifier.urihttp://hdl.handle.net/20.500.12904/14994
dc.description.abstractObjective: To describe and critique tools used to assess frailty in vascular surgery patients, and investigate its associations with patient factors and outcomes. Background: Increasing evidence shows negative impacts of frailty on outcomes in surgical patients, but little investigation of its associations with patient factors has been undertaken. Methods: Systematic review and meta-analysis of studies reporting frailty in vascular surgery patients (PROSPERO registration: CRD42018116253) searching Medline, Embase, CINAHL, PsycINFO, and Scopus. Quality of studies was assessed using Newcastle-Ottawa scores (NOS) and quality of evidence using Grading of Recommendations Assessment, Development, and Evaluation criteria. Associations of frailty with patient factors were investigated by difference in means (MD) or expressed as risk ratios (RRs), and associations with outcomes expressed as odds ratios (ORs) or hazard ratios (HRs). Data were pooled using random-effects models. Results: Fifty-three studies were included in the review and only 8 (15%) were both good quality (NOS ≥ 7) and used a well-validated frailty measure. Eighteen studies (62,976 patients) provided data for the meta-analysis. Frailty was associated with increased age [MD 4.05 years; 95% confidence interval (CI) 3.35, 4.75], female sex (RR 1.32; 95% CI 1.14, 1.54), and lower body mass index (MD -1.81; 95% CI -2.94, -0.68). Frailty was associated with 30-day mortality [adjusted OR (AOR) 2.77; 95% CI 2.01-3.81), postoperative complications (AOR 2.16; 95% CI 1.55, 3.02), and long-term mortality (HR 1.85; 95% CI 1.31, 2.62). Sarcopenia was not associated with any outcomes. Conclusion: Frailty, but not sarcopenia, is associated with worse outcomes in vascular surgery patients. Well-validated frailty assessment tools should be preferred clinically, and in future research.
dc.description.urihttps://journals.lww.com/annalsofsurgery/Abstract/2020/08000/Frailty_Factors_and_Outcomes_in_Vascular_Surgery.59.aspxen_US
dc.subjectFrailtyen_US
dc.subjectMeta-analysisen_US
dc.subjectSarcopeniaen_US
dc.subjectVascular surgeryen_US
dc.titleFrailty factors and outcomes in vascular surgery patients: a systematic review and meta-analysisen_US
dc.typeArticleen_US
rioxxterms.funderDefault funderen_US
rioxxterms.identifier.projectDefault projecten_US
rioxxterms.versionNAen_US
rioxxterms.typeJournal Article/Reviewen_US
refterms.panelUnspecifieden_US
html.description.abstractObjective: To describe and critique tools used to assess frailty in vascular surgery patients, and investigate its associations with patient factors and outcomes. Background: Increasing evidence shows negative impacts of frailty on outcomes in surgical patients, but little investigation of its associations with patient factors has been undertaken. Methods: Systematic review and meta-analysis of studies reporting frailty in vascular surgery patients (PROSPERO registration: CRD42018116253) searching Medline, Embase, CINAHL, PsycINFO, and Scopus. Quality of studies was assessed using Newcastle-Ottawa scores (NOS) and quality of evidence using Grading of Recommendations Assessment, Development, and Evaluation criteria. Associations of frailty with patient factors were investigated by difference in means (MD) or expressed as risk ratios (RRs), and associations with outcomes expressed as odds ratios (ORs) or hazard ratios (HRs). Data were pooled using random-effects models. Results: Fifty-three studies were included in the review and only 8 (15%) were both good quality (NOS ≥ 7) and used a well-validated frailty measure. Eighteen studies (62,976 patients) provided data for the meta-analysis. Frailty was associated with increased age [MD 4.05 years; 95% confidence interval (CI) 3.35, 4.75], female sex (RR 1.32; 95% CI 1.14, 1.54), and lower body mass index (MD -1.81; 95% CI -2.94, -0.68). Frailty was associated with 30-day mortality [adjusted OR (AOR) 2.77; 95% CI 2.01-3.81), postoperative complications (AOR 2.16; 95% CI 1.55, 3.02), and long-term mortality (HR 1.85; 95% CI 1.31, 2.62). Sarcopenia was not associated with any outcomes. Conclusion: Frailty, but not sarcopenia, is associated with worse outcomes in vascular surgery patients. Well-validated frailty assessment tools should be preferred clinically, and in future research.en_US
rioxxterms.funder.project94a427429a5bcfef7dd04c33360d80cden_US


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