Interventions to improve the outcomes of frail people having surgery: A systematic review

PloS One
Daniel I McIsaacManoj M Lalu

Abstract

Frailty is an important prognostic factor for adverse outcomes and increased resource use in the growing population of older surgical patients. We identified and appraised studies that tested interventions in populations of frail surgical patients to improve perioperative outcomes. We systematically searched Cochrane, CINAHL, EMBASE and Medline to identify studies that tested interventions in populations of frail patients having surgery. All phases of study selection, data extraction, and risk of bias assessment were done in duplicate. Results were synthesized qualitatively per a prespecified protocol (CRD42016039909). We identified 2 593 titles; 11 were included for final analysis, representing 1 668 participants in orthopedic, general, cardiac, and mixed surgical populations. Only one study was multicenter and risk of bias was moderate to high in all studies. Interventions were applied pre- and postoperatively, and included exercise therapy (n = 4), multicomponent geriatric care protocols (n = 5), and blood transfusion triggers (n = 1); no specific surgical techniques were compared. Exercise therapy, applied pre-, or post-operatively, was associated with significant improvements in functional outcomes and improved quality of ...Continue Reading

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Citations

Sep 11, 2018·Expert Review of Cardiovascular Therapy·Umair ShafiqueAsim N Cheema
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Methods Mentioned

BETA
total hip arthroplasty

Software Mentioned

Cochrane Risk of Bias Tool
DistillerSR®

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