Abstract：
BACKGROUND: Considered to reflect a patients\' biological age, frailty is a new syndrome shown to predict surgical outcomes in elderly patients. In view of the increasing age at which patients are proposed oncological liver surgery and the morbidity associated with it, we attempted to perform a systematic review and meta-analysis to compare morbidity and mortality between frail and nonfrail patients after liver resections.
METHODS: The study was registered with PROSPERO. A systematic search of PubMed and EMBASE databases was performed for all comparative studies examining surgical outcomes after liver resections between frail and nonfrail patients.
RESULTS: Ten studies were included based on the selection criteria with a total of 71,102 patients, split into two groups: frail (n = 17,167) and the control group (n = 53,928). There were more elderly patients with a lower preoperative albumin level in the frail group (p = 0.02, p = 0.001). Frail patients showed higher rates of morbidity with more major complications and a higher incidence of postoperative liver failure (p < 0.001). Mortality (p < 0.001) and readmission rate (p = 0.021) also was higher in frail patients.
CONCLUSIONS: Frailty seems to be a solid predictive risk factor of morbidity and mortality after liver surgery and should be considered a selection criterion for liver surgery in at-risk patients.
METHODS: The study was registered with PROSPERO. A systematic search of PubMed and EMBASE databases was performed for all comparative studies examining surgical outcomes after liver resections between frail and nonfrail patients.
RESULTS: Ten studies were included based on the selection criteria with a total of 71,102 patients, split into two groups: frail (n = 17,167) and the control group (n = 53,928). There were more elderly patients with a lower preoperative albumin level in the frail group (p = 0.02, p = 0.001). Frail patients showed higher rates of morbidity with more major complications and a higher incidence of postoperative liver failure (p < 0.001). Mortality (p < 0.001) and readmission rate (p = 0.021) also was higher in frail patients.
CONCLUSIONS: Frailty seems to be a solid predictive risk factor of morbidity and mortality after liver surgery and should be considered a selection criterion for liver surgery in at-risk patients.
摘要：
背景：被认为反映了患者的生物学年龄，虚弱是一种新的综合征，可预测老年患者的手术结局。鉴于患者被提议进行肿瘤肝脏手术的年龄越来越大以及与之相关的发病率，我们尝试进行系统回顾和荟萃分析,以比较肝脏切除后体弱和非体弱患者的发病率和死亡率.
方法：本研究在PROSPERO注册。对PubMed和EMBASE数据库进行了系统搜索，以进行所有比较研究，以检查体弱和非体弱患者肝脏切除术后的手术结果。
结果：根据选择标准纳入了10项研究，共有71,102名患者，分为两组：体弱者（n=17,167）和对照组（n=53,928）。虚弱组患者术前白蛋白水平较低(p=0.02,p=0.001)。虚弱的患者显示出更高的发病率，更多的主要并发症和更高的术后肝功能衰竭的发生率（p<0.001）。虚弱患者的死亡率（p<0.001）和再入院率（p=0.021）也较高。
结论：脆弱似乎是肝脏手术后发病率和死亡率的可靠预测危险因素，应被视为高危患者肝脏手术的选择标准。
方法：本研究在PROSPERO注册。对PubMed和EMBASE数据库进行了系统搜索，以进行所有比较研究，以检查体弱和非体弱患者肝脏切除术后的手术结果。
结果：根据选择标准纳入了10项研究，共有71,102名患者，分为两组：体弱者（n=17,167）和对照组（n=53,928）。虚弱组患者术前白蛋白水平较低(p=0.02,p=0.001)。虚弱的患者显示出更高的发病率，更多的主要并发症和更高的术后肝功能衰竭的发生率（p<0.001）。虚弱患者的死亡率（p<0.001）和再入院率（p=0.021）也较高。
结论：脆弱似乎是肝脏手术后发病率和死亡率的可靠预测危险因素，应被视为高危患者肝脏手术的选择标准。
