Association between frailty and clinical post-operative outcomes in patients following hip arthroplasty: a systematic review and meta-analysis

Abstract

Purpose: This research determined the correlation between frailty and post-surgical complications, readmission, re-operation, and mortality in patients with hip arthroplasty through a meta-analysis.

Methods: We screened PubMed, Web of Science, Embase, and the Cochrane Library for cohort research that explored the correlation between frailty and post-operative complications in patients who underwent hip arthroplasty from inception to August 31, 2022. The Newcastle-Ottawa scale was employed to assess the value of the involved studies. Statistical analyses of the meta-analysis were conducted utilizing Review Manager, version 5.3.

Results: This research involved seven retrospective investigations involving 350,971 patients. The summed findings revealed that frailty is associated with total complications (relative risk [RR] = 3.07, 95% confidence interval [CI]:1.99-4.74), re-operation (RR = 1.98; 95% CI: 1.73-2.28), readmission (RR = 2.04; 95% CI: 1.87-2.22), and 30-day mortality (RR = 2.59, 95% CI: 1.16-5.79). Subgroup and sensitivity analyses revealed that the pooled findings of frailty predict that total complications, re-operation, readmission, and 30-day mortality were stable.

Conclusions: Pre-operative frailty was correlated with post-surgical complications in patients who underwent hip arthroplasty, including post-operative complications, re-operation, readmission, and 30-day mortality.

Systematic review registration: PROSPERO, identifier: CRD 42022350781.

Keywords: Frailty; Hip arthroplasty; Meta-analysis; Mortality; Post-operative complications.