Study | Condition studied | Study design | Number of participants | Participant characteristics | Frailty scale used and percentage | Outcomes | Results |
---|---|---|---|---|---|---|---|
Cloney et al 2015 [35] | frailty in patients with glioblastoma | Retrospective cohort study in elective surgery | 243 patients | Age > 65 | MFI 11 81% frail | -Association between mFI score and the decision to forego surgical resection -rate of postoperative complications, -Length of hospital stay, -Overall mortality; | -Frailer patients were less likely to undergo surgical resection, as opposed to a biopsy, had longer hospital stays, an increased overall risk of complications, and decreased overall survival; |
Harland et al. 2020 [37] | frailty in patients undergoing tumour surgery | Prospective cohort study in elective surgery | 260 patients | Age > 18 | John Hopkins Frailty Instrument 25% frail | -Postoperative complications within 30 days of surgery, including mortality; -new neurologic deficit; -LOS; -discharge to a skilled nursing facility, acute rehabilitation facility, or hospice at 30 days when previously independent | -Preoperative frailty was associated with an increased risk for discharge to a location other than home, postoperative complications; |
Henry et al. 2021 [38] | skull base procedures National Surgical Quality Improvement Program (NSQIP) database from 2005 to 2018 | Retrospective cohort study—trauma cases were excluded | 17912 | Age > 18 | 5 Factor Modified Frailty Index 45% frail | Primary outcome variables included rates of overall complications and life-threatening complications within the 30-day postoperative period. | -Independent predictor of overall complications life-threatening complications, and mortality. |
Huq et al. 2021 [15] | Frailty in brain tumor patients | Single-center retrospective cohort study primary brain surgery | 1692 | Age > 18 | 5 Factor Modified Frailty Index 57% frail | Total length of stay (LOS), intensive care unit (ICU) LOS, complications, charges, and 30-d readmissions) | -Mean intensive care unit (ICU) and total LOS were 1.69 and 5.24 days respectively. Mean pulmonary embolism (PE)/deep vein thrombosis (DVT), physiological/metabolic derangement, respiratory failure, and sepsis rates were 7.2%, 1.1%, 1.6%, and 1.7%, respectively. Mean total charges were $42,331; |
Imaoka et al. 2018 [36] | Frailty in patients undergoing treatment for spontaneous cerebral hemorrhage | Single-center retrospective cohort study—no trauma cases | 156 | Age > 18 | 11 Factor Modified Frailty Index 75% frail | Outcome measures included an unfavorable outcome (modified Rankin Scale score of 4–6) or mortality at 6–8 months after hemorrhage. | -Higher mFI was significantly associated with an unfavorable outcome (p value = 0.004) and mortality |
Shahrestani et al. 2020 [16] | Frailty in patients undergoing primary tumor surgery | Primary CNS neoplasm between 2010 and 2017 by using the Nationwide Readmission Database | 13342 | Age > 65 | JHACG 50% frail | -Demographics and frailty were queried at primary admission, and readmissions were analyzed at 30-, 90-, and 180-day intervals; complications of interest included infection, anemia, infarction, kidney injury, CSF leak, urinary tract infection, and mortality; | -Mortality was increased compared to non-frail geriatric patients receiving the same procedure; frail patients had a significantly increased inpatient length of stay (p < 0.0001) and all-payer hospital cost (p < 0.0001) compared to non-frail patients at the time of primary admission. |
Theriault 2020 [40] | Primary tumor surgery | Single-center retrospective cohort study of patients who underwent intracranial meningioma resection | 76 patients | Age> 18 | 5 Factor Modified Frailty Index; 55% frail | LOS (length of stay), discharge location, readmission rates, and reoperation rates; | -Increased hospital LOS (p = 0.0218), increased reoperation rate (p = 0.029), and discharge to a higher level of care; |
Sastry et al. 2020 [39] | Primary tumor surgery | Retrospective cohort 2012–2018 ACS-NSQIP participant use file | 20,333 | Age> 18 | 5 Factor Modified Frailty Index 41% frail | incidence of major postoperative complications, discharge destination other than home, 30-day readmission, and 30-day mortality after elective craniotomy for brain tumor resection. | - Both low and medium-high frailty were associated with increased adjusted odds ratio of major complications, discharge destination other than home, and 30-day mortality; |
Youngerman et al. 2017 [17] | Primary tumor surgery | NSQIP 2008–2012 | 9149 | Age> 18 | 11 Factor Modified Frailty Index 49% frail | 30-day mortality, 30-day severe medical complications, 30-day severe neurologic complications, 30-day any complication, extended length of stay (LOS), and unfavorable disposition | -mFI was associated with stepwise increases in the rates of mortality, severe medical complications, prolonged length of stay, and unfavorable discharge; |