Abstract：
BACKGROUND: The Clinical Frailty Scale (CFS) is a 9-point scaling system used to categorise the frailty of patients. The CFS is well-established as a prognostic tool for decision-making within healthcare settings. However, the relationship between the CFS as a predictor for orthopaedic outcomes is limited. This review aims to provide an overview of the efficacy of the CFS as a prognostic tool for predicting orthopaedic outcomes.
METHODS: Systematic review using PRISMA checklist (PROSPERO registered: CRD42023456648). Ovid and PubMed databases were searched using defined search terms to identify English language papers between 2007 and June 2023 which fit the inclusion criteria. Abstract screening was carried out independently and included studies proceeded to full-text review.
RESULTS: 10 studies were identified. Studies used a range of outcome measures to assess success, including gross outcomes like mortality rates, as well as more specific functional outcomes, such as joint functionality scores. Studies identified that higher CFS scores correlate to poorer outcomes within orthopaedic patients. These include higher rates of mortality (41.7 % at one-year post proximal femur fracture for CFS ≥ 7), longer length of hospital stay and increased risk of adverse events post-procedure (both increased linearly from CFS 1 to 4). Additionally, the CFS was shown to be a strong prognostic tool when compared to other frailty scales. The number of studies that evaluated the relationship between the CFS and joint functionality scores is limited.
CONCLUSIONS: Higher CFS scores are associated with poorer orthopaedic outcomes. However, it is difficult to quantify the true impact due to the limited number of high-quality studies. Further work to characterise the relationship between both gross and functional outcomes associated with the utilisation of the CFS in orthopaedic settings is essential to ascertain the utility of this simple score to improve resource allocation and provide effective consent to patients.
METHODS: Systematic review using PRISMA checklist (PROSPERO registered: CRD42023456648). Ovid and PubMed databases were searched using defined search terms to identify English language papers between 2007 and June 2023 which fit the inclusion criteria. Abstract screening was carried out independently and included studies proceeded to full-text review.
RESULTS: 10 studies were identified. Studies used a range of outcome measures to assess success, including gross outcomes like mortality rates, as well as more specific functional outcomes, such as joint functionality scores. Studies identified that higher CFS scores correlate to poorer outcomes within orthopaedic patients. These include higher rates of mortality (41.7 % at one-year post proximal femur fracture for CFS ≥ 7), longer length of hospital stay and increased risk of adverse events post-procedure (both increased linearly from CFS 1 to 4). Additionally, the CFS was shown to be a strong prognostic tool when compared to other frailty scales. The number of studies that evaluated the relationship between the CFS and joint functionality scores is limited.
CONCLUSIONS: Higher CFS scores are associated with poorer orthopaedic outcomes. However, it is difficult to quantify the true impact due to the limited number of high-quality studies. Further work to characterise the relationship between both gross and functional outcomes associated with the utilisation of the CFS in orthopaedic settings is essential to ascertain the utility of this simple score to improve resource allocation and provide effective consent to patients.
摘要：
背景：临床衰弱量表（CFS）是一种9点缩放系统，用于对患者的衰弱进行分类。CFS已作为医疗保健环境中决策的预后工具而确立。然而,CFS作为骨科预后预测因子之间的关系有限.这篇综述旨在概述CFS作为预测骨科结果的预后工具的功效。
方法：使用PRISMA检查表进行系统审查（PROSPERO注册：CRD42023456648）。使用定义的搜索词搜索Ovid和PubMed数据库，以识别2007年至2023年6月之间符合纳入标准的英语论文。摘要筛选独立进行，纳入研究进行全文回顾。
结果：确定了10项研究。研究使用了一系列结果指标来评估成功，包括死亡率等总体结果，以及更具体的功能结果，如联合功能评分。研究发现，较高的CFS评分与骨科患者预后较差相关。这些包括较高的死亡率（对于CFS≥7的患者，股骨近端骨折后一年为41.7%），住院时间延长和术后不良事件风险增加(两者均从CFS1线性增加到4).此外,与其他衰弱量表相比,CFS被证明是一个强有力的预后工具.评估CFS与关节功能评分之间关系的研究数量有限。
结论：较高的CFS评分与较差的骨科预后相关。然而,由于高质量研究的数量有限,因此很难量化真正的影响.进一步的工作来表征与在骨科设置中使用CFS相关的总体结果和功能结果之间的关系对于确定该简单评分的效用以改善资源分配并向患者提供有效同意至关重要。
方法：使用PRISMA检查表进行系统审查（PROSPERO注册：CRD42023456648）。使用定义的搜索词搜索Ovid和PubMed数据库，以识别2007年至2023年6月之间符合纳入标准的英语论文。摘要筛选独立进行，纳入研究进行全文回顾。
结果：确定了10项研究。研究使用了一系列结果指标来评估成功，包括死亡率等总体结果，以及更具体的功能结果，如联合功能评分。研究发现，较高的CFS评分与骨科患者预后较差相关。这些包括较高的死亡率（对于CFS≥7的患者，股骨近端骨折后一年为41.7%），住院时间延长和术后不良事件风险增加(两者均从CFS1线性增加到4).此外,与其他衰弱量表相比,CFS被证明是一个强有力的预后工具.评估CFS与关节功能评分之间关系的研究数量有限。
结论：较高的CFS评分与较差的骨科预后相关。然而,由于高质量研究的数量有限,因此很难量化真正的影响.进一步的工作来表征与在骨科设置中使用CFS相关的总体结果和功能结果之间的关系对于确定该简单评分的效用以改善资源分配并向患者提供有效同意至关重要。
