JMIR Publications

ABSTRACT

Background:

Frailty is an aggregate expression of susceptibility to adverse health outcomes because of age-related and disease-related deficits that accumulate across multiple domains. Previous studies have found the presence of preoperative frailty is associated with an increased adverse outcome risk. The number of older people undergoing orthopedic surgery is rapidly increasing. However, there is no evidence-based study on the relationship between frailty and outcomes in orthopedic surgery patients.

Objective:

The aims of this study were: 1) to describe and critique the tools which are used to assess the frailty in orthopedic surgery patients and the quality of evidence for their use; 2) to investigate frailty associated with outcomes and patient factors associated with frailty in orthopedic surgery patients.

Methods:

The methods of this systematic review are reported according to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) Protocols 2015 checklist. An extensive search will be conducted in PUBMED, EMBASE, the Cochrane Library, and any other mainstream databases. Any study that involved orthopedic patients assessed using a defined or validated measure of frailty; and reported on either association of frailty with patient factors and/or outcomes will be included. Two researchers will independently screen articles for inclusion, with disagreements resolved by a third reviewer. We will perform a narrative synthesis around the validity of tools in frailty assessment, factors associated with frailty, the prevalence of frailty, the effect of frailty on the outcomes of patients, and the interventions to frailty. Meta-analysis about individual factors associated with frailty and the effect of frailty on the outcomes of patients will be performed, if applicable. The risk of bias will be evaluated. Subgroup analysis, sensitivity analysis will be performed.

Results:

The preliminary retrieval process has been completed. The follow-up process are ready to begin. The results of this review plans to publish at September 2021.

Conclusions:

Frailty is prevalent in older adults. They always suffer from orthopedic diseases and need to undergo procedures. Studies have confirmed the association between frailty and negative outcomes. It is important to detect and intervene frailty in time. However, no robust evidence-based studies specialized on the relationship between them. We hope this study will help clinical specialties embrace the concept of frailty and enhance the development of assessment instruments and tools. Clinical Trial: International Prospective Register of Systematic Reviews (PROSPERO) CRD42020181846;