The impact of frailty on acute care general surgery patients: A systematic review.

Abstract

Frailty may predict negative health outcomes more accurately than chronological age alone. This review examines evidence for the impact of frailty on adverse outcomes in patients admitted with an acute care general surgery (ACS) diagnosis. A systematic literature search for studies reporting frailty and outcomes after admission with an ACS diagnosis was performed. We searched PubMed and SCOPUS from inception until September 2017. A total of 8,668 records were screened, of which seven studies examined the relationship between frailty and outcomes in ACS patients. Frailty was associated with higher 30-day mortality patients (odds ratio, 3.04; 95% confidence interval, 2.67-3.46; p < 0.01), postoperative complications, length of stay, institutional discharge, and critical care admission. There is emerging evidence that frailty is associated with worse outcomes in patients with an unplanned admission due to an ACS diagnosis. Further investigation is warranted with regard to how frailty may impact patients with an acute illness more severely. Systematic review, level III.