Author/ Year

Journal

Country of origin

Objectives

Results

Study design

Sample size

Level of evidence

Neuman et al., 2013 [17]

Ann Surg Oncol

USA

To analyze overall survival at 90 days and 1 year after elective colectomy for stage I - III colon cancer from 1992 to 2005.

The overall survival after elective colectomy for colon cancer was 93.4% and 85.7% at 90 days and 1 year, respectively. Old age, male gender, frailty, increase in hospitalizations in the previous year and dementia were more strongly associated with decreased survival. Although only 4.4% of the patients were frail, there was a strong association with mortality, with an odds ratio of 8.4 (95% CI: 6.4 - 11.1).

Retrospective cohort

12,979

2B

Kim et al., 2014 [18]

Jama Surg

KO

To develop a predictive model for adverse outcomes in elderly surgical patients.

In the model developed, high-risk patients (multidimensional frailty score > 5) presented a higher risk of postoperative mortality (OR: 9.01; 95% CI: 2.15 - 37.78, p = 0.003).

Longitudinal cohort

275

2C

McIssac; Bryson; Van Walrave, 2016 [19]

Jama Surg

USA

To evaluate the effect of patient frailty at the population level and its association with one-year postoperative mortality from elective major non-cardiac surgery.

After one year, 13.6% of the frail and 4.8% of the non-frail individuals died. The adjustment for sociodemographic and surgical confounders resulted in a risk ratio of 2.23 (95% CI: 2.08 - 2.40). There was an increased relative death risk in frail patients (RR: 35.5; 95% CI: 29.7 - 40.1) on the third postoperative day. The association between frailty and increased death risk decreased with patient age (HR: 2.66; 95% CI: 2.28 - 3.10 at age 65; HR: 1.63; 95% CI: 1.36 - 1.95 at age 90).

Longitudinal cohort

202,811

2B

Augustin et al., 2016 [20]

Surgery

USA

To analyze the relationship between mFI and postoperative outcomes in patients undergoing pancreatectomy, using the National Surgical Quality Improvement Project database.

Death in the non-frail group was 0.6%, 1.1% for mild frailty, 3.1% for intermediate frailty and 11.1% for frailty, p < 0.01. The relationship between frailty and mortality showed that frail patients had a proportional mortality rate 22 times higher when compared to non-frail ones.

Cross- sectional

13,020

2C

Hubbard et al., 2017 [21]

Age and Ageing

AU

To investigate the discriminative capacity of the InterRAI Comprehensive Geriatric Assessment-derived FI for acute care in relation to multiple adverse outcomes in inpatients.

A 0.1 increase in FI was significantly associated with hospitalization time > 28 days (OR: 1.29; 95% CI: 1.10 - 1.52), falls (OR: 1.29; 95% CI: 1.10 - 1.50), delirium (OR: 2.34; 95% CI: 2.08 - 2.63), incidence of pressure ulcers (OR: 1.51; 95% CI: 1.23 - 1.87) and mortality (OR: 2.01; 95% CI: 1.66 - 2.42).

Longitudinal cohort

1418

2B

Yuki et al., 2018 [22]

Geriat Gerontol Int

JP

Evaluate the association between frailty and mortality.

Frailty was identified in men aged 65 - 74 years old and women aged 75 - 84 years old. Weakness and exhaustion prevailed. There was an association between frailty and death among Japanese older adults (p < 0.01).

Longitudinal cohort

841

2B

Belaunde et al., 2020 [23]

Rev Cub Med Mil

CUB

To determine prognostic factors for mortality in frail older adults.

Frail older adults have a mortality risk of 62% (95% CI: 48 - 76), when compared to non-frail ones.

Longitudinal cohort

50

2B