{"title":"作为肝切除术患者不良预后预测因素的虚弱程度--改善虚弱程度的设计研究的重要性:128 868 例患者的系统回顾和荟萃分析。","authors":"Fei Zhang, Ying Yan, Baifeng Li, Chunlin Ge","doi":"10.1002/jhbp.12075","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>Frailty has been associated with increased mortality among patients with surgery. However, evidence about the frailty prevalence and outcomes in frail populations with hepatectomy is inconsistent and has not been clarified. The purpose of this study was to quantitatively synthesize the prevalence of frailty and the role of frailty on mortality in patients with hepatectomy.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>Embase, PubMed, Scopus, and Web of Science were searched for eligible studies that explored the prevalence and impact of frailty in hepatectomy from inception until January 24, 2024. The pooled prevalence of frailty and odds ratio (OR) corresponding 95% confidence intervals (CI) in mortality and major complications estimates were analyzed.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>A total of 26 studies containing 128 868 patients with hepatectomy were included. The prevalence of frailty in hepatectomy was 23% (95% CI: 17–28; <i>p</i> = .000). Frailty was associated with an increased odds ratio for mortality (adjusted OR = 3.06; 95% CI: 1.85–5.04; <i>p</i> = .000). Furthermore, frailty was significantly associated with an increased odds ratio for major complications (adjusted OR = 3.20; 95% CI: 2.04–5.04; <i>p</i> < .01).</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>The prevalence of frailty in patients with hepatectomy is prevalent, which has a significant adverse impact on the outcomes of patients with hepatectomy. These findings highlight the importance of frailty assessment in this population, which may provide prognostic details.</p>\n </section>\n </div>","PeriodicalId":16056,"journal":{"name":"Journal of Hepato‐Biliary‐Pancreatic Sciences","volume":"31 12","pages":"851-862"},"PeriodicalIF":3.2000,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Frailty as a predictor of adverse outcomes in patients with hepatectomy - the importance of design studies to improve frailty: A systematic review and meta-analysis of 128 868 patients\",\"authors\":\"Fei Zhang, Ying Yan, Baifeng Li, Chunlin Ge\",\"doi\":\"10.1002/jhbp.12075\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Background</h3>\\n \\n <p>Frailty has been associated with increased mortality among patients with surgery. However, evidence about the frailty prevalence and outcomes in frail populations with hepatectomy is inconsistent and has not been clarified. The purpose of this study was to quantitatively synthesize the prevalence of frailty and the role of frailty on mortality in patients with hepatectomy.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>Embase, PubMed, Scopus, and Web of Science were searched for eligible studies that explored the prevalence and impact of frailty in hepatectomy from inception until January 24, 2024. The pooled prevalence of frailty and odds ratio (OR) corresponding 95% confidence intervals (CI) in mortality and major complications estimates were analyzed.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>A total of 26 studies containing 128 868 patients with hepatectomy were included. The prevalence of frailty in hepatectomy was 23% (95% CI: 17–28; <i>p</i> = .000). Frailty was associated with an increased odds ratio for mortality (adjusted OR = 3.06; 95% CI: 1.85–5.04; <i>p</i> = .000). Furthermore, frailty was significantly associated with an increased odds ratio for major complications (adjusted OR = 3.20; 95% CI: 2.04–5.04; <i>p</i> < .01).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusion</h3>\\n \\n <p>The prevalence of frailty in patients with hepatectomy is prevalent, which has a significant adverse impact on the outcomes of patients with hepatectomy. These findings highlight the importance of frailty assessment in this population, which may provide prognostic details.</p>\\n </section>\\n </div>\",\"PeriodicalId\":16056,\"journal\":{\"name\":\"Journal of Hepato‐Biliary‐Pancreatic Sciences\",\"volume\":\"31 12\",\"pages\":\"851-862\"},\"PeriodicalIF\":3.2000,\"publicationDate\":\"2024-10-21\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Hepato‐Biliary‐Pancreatic Sciences\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1002/jhbp.12075\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"GASTROENTEROLOGY & HEPATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Hepato‐Biliary‐Pancreatic Sciences","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/jhbp.12075","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
背景:体弱与手术患者死亡率的增加有关。然而,有关肝切除术后虚弱人群的虚弱发生率和结局的证据并不一致,也没有得到澄清。本研究旨在定量综合肝切除术患者的虚弱发生率以及虚弱对死亡率的影响:方法:在 Embase、PubMed、Scopus 和 Web of Science 中检索了从开始到 2024 年 1 月 24 日期间探讨肝切除术中虚弱的流行率和影响的符合条件的研究。分析了合并的虚弱患病率以及死亡率和主要并发症估计值中相应的 95% 置信区间 (CI) 的几率比 (OR):结果:共纳入 26 项研究,包含 128 868 名肝切除术患者。肝切除术中体弱的发生率为 23% (95% CI: 17-28; p = .000)。虚弱与死亡率的几率增加有关(调整后 OR = 3.06;95% CI:1.85-5.04;p = .000)。此外,虚弱与主要并发症的几率增加也有明显关系(调整后 OR = 3.20;95% CI:2.04-5.04;P 结论:虚弱与主要并发症的几率增加也有明显关系(调整后 OR = 3.20;95% CI:2.04-5.04):肝切除术患者普遍体弱,这对肝切除术患者的预后有很大的不利影响。这些研究结果突显了对这一人群进行虚弱程度评估的重要性,该评估可提供预后方面的详细信息。
Frailty as a predictor of adverse outcomes in patients with hepatectomy - the importance of design studies to improve frailty: A systematic review and meta-analysis of 128 868 patients
Background
Frailty has been associated with increased mortality among patients with surgery. However, evidence about the frailty prevalence and outcomes in frail populations with hepatectomy is inconsistent and has not been clarified. The purpose of this study was to quantitatively synthesize the prevalence of frailty and the role of frailty on mortality in patients with hepatectomy.
Methods
Embase, PubMed, Scopus, and Web of Science were searched for eligible studies that explored the prevalence and impact of frailty in hepatectomy from inception until January 24, 2024. The pooled prevalence of frailty and odds ratio (OR) corresponding 95% confidence intervals (CI) in mortality and major complications estimates were analyzed.
Results
A total of 26 studies containing 128 868 patients with hepatectomy were included. The prevalence of frailty in hepatectomy was 23% (95% CI: 17–28; p = .000). Frailty was associated with an increased odds ratio for mortality (adjusted OR = 3.06; 95% CI: 1.85–5.04; p = .000). Furthermore, frailty was significantly associated with an increased odds ratio for major complications (adjusted OR = 3.20; 95% CI: 2.04–5.04; p < .01).
Conclusion
The prevalence of frailty in patients with hepatectomy is prevalent, which has a significant adverse impact on the outcomes of patients with hepatectomy. These findings highlight the importance of frailty assessment in this population, which may provide prognostic details.
期刊介绍:
The Journal of Hepato-Biliary-Pancreatic Sciences (JHBPS) is the leading peer-reviewed journal in the field of hepato-biliary-pancreatic sciences. JHBPS publishes articles dealing with clinical research as well as translational research on all aspects of this field. Coverage includes Original Article, Review Article, Images of Interest, Rapid Communication and an announcement section. Letters to the Editor and comments on the journal’s policies or content are also included. JHBPS welcomes submissions from surgeons, physicians, endoscopists, radiologists, oncologists, and pathologists.