"Age is just a number"; frailty as a marker of peri‐operative risk in head and neck surgery: Systematic review and meta‐analysis. Issue 8 (2nd June 2022)

• Record Type: Journal Article
• Authors: Cleere, Eoin F.; Davey, Matthew G.; O'Neill, James P.
• Is Part Of: Head & neck. Volume 44:Issue 8(2022)
• Page Start: 1927
• Page End: 1939
• Publication Date: 2022-06-02
• Subjects: elderly -- frailty -- head and neck -- morbidity -- oncogeriatrics; Head -- Diseases -- Periodicals; Neck -- Diseases -- Periodicals; Head -- Periodicals; Neck -- Periodicals; Face -- Periodicals; 617.51059
• DOI: 10.1002/hed.27110
• Languages: English
• ISSNs: 1043-3074

Abstract

Abstract: Background: Frailty refers to a patient's reduced capacity to withstand stressors due to a reduction in physiologic reserves. We assessed the impact of frailty on outcomes following head and neck surgery. Methods: We performed a systematic review in accordance with the PRISMA guidelines. Meta‐analysis was performed using the Mantel–Haenszel method. Results: Fourteen studies incorporating 182 059 patients were included in qualitative synthesis with 15 953 (8.8%) of patients deemed as frail. Meta‐analysis incorporating nine studies demonstrated that frailty is associated with an increased 30 day postoperative morbidity (OR 2.74; 95% CI 1.98–3.80; p < 0.01) and meta‐analysis with six studies suggested increased 30‐day mortality (OR 2.94; 95% CI 2.62–3.31; p < 0.01). Preliminary meta‐analyses between two and five studies suggested that frail patients had reduced overall survival and were more likely to be discharged to a nonhome location or readmitted within 30 days. Conclusions: Frailty appears to be associated with poor short‐term outcomes following head and neck surgery and may improve understanding of an individual patient's peri‐operative risk.