METHODS: We conducted a systematic review and meta-analysis following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Relevant papers through December 2023 were retrieved from PubMed, Scopus, Web of science, and Embase.
RESULTS: A total of 5 studies met inclusion/exclusion criteria with an aggregate 39,221 non-frail patients (mean age 52.4 ± 5.2 yr; 62.1 % Female), and 79,416 frail patients (mean age 61.1 ± 5.4 yr; 69.0 % Female). Frailty was significantly associated with higher mortality ratio (Odds ratio (OR)= 2.09; CI [1.04: 4.20], p= 0.04), and increased length of hospital stay (OR= 1.40; CI [1.07: 1.83], p= 0.015). Additionally, frailty was associated with higher odds of external ventricular drain insertion, the need of tracheostomy/endoscopic gastrostomy, increased risk of deep vein thrombosis, and postoperative neurological complications.
CONCLUSIONS: Frailty is associated with worse clinical outcomes and higher mortality rates in SAH patients. Our findings highlight that frailty, when considered alongside other established prognostic factors, serves as crucial predictor for peri-operative complications and overall hospital course in SAH patients.
方法:我们遵循系统评价和荟萃分析(PRISMA)指南的首选报告项目进行了系统评价和荟萃分析。截至2023年12月的相关论文来自PubMed,Scopus,WebofScience,和Embase。
结果:共有5项研究符合纳入/排除标准,共有39,221名非虚弱患者(平均年龄52.4±5.2岁;62.1%为女性),79,416名虚弱患者(平均年龄61.1±5.4岁;69.0%为女性)。虚弱与较高的死亡率显著相关(赔率比(OR)=2.09;CI[1.04:4.20],p=0.04),住院时间增加(OR=1.40;CI[1.07:1.83],p=0.015)。此外,虚弱与外部心室引流管插入的几率较高相关,需要气管造口术/内窥镜胃造瘘术,深静脉血栓形成的风险增加,和术后神经系统并发症。
结论:SAH患者的虚弱与较差的临床结局和较高的死亡率相关。我们的发现强调了脆弱,当与其他既定的预后因素一起考虑时,作为SAH患者围手术期并发症和整体住院时间的关键预测因子。