Clin Cardiol. 5 Jul 2018, doi: 10.1002/clc.23021
- Analysis of 12 studies concludes that addition of frailty measures to existing preioperative risk models improved the prediction performance for mortality, but the incorporation of frailty assessment into the perioperative risk assessment needs further evidence before making health policy recommendations.
Abstract
BACKGROUND: Emerging evidence demonstrate that frailty measures can predict adverse outcomes after cardiac procedures. Our objective was to examine whether the inclusion of frailty measures adds incremental predictive value on existing surgical risk prediction models in patients undergoing cardiac surgery, and evaluate the reporting and methods of studies that investigated the prediction of frailty measures in cardiology.
HYPOTHESIS: The inclusion of frailty measures adds incremental predictive value on existing perioperative risk scoring systems.
METHODS:
We systematically searched the EMBASE, MEDLINE, and Web of Science databases for relevant studies. Studies were included according to predefined inclusion criteria. Quality of included studies was appraised using the QUADAS-2 tool. Data were extracted and synthesized according to predefined methods.
RESULTS:
Twelve studies were included analysis. Included studies demonstrated the incremental predictive value of frailty measures on existing surgical risk models for mortality, but the predictive value of frailty measures alone was not consistent across literature. Few studies that investigated the predictive ability of frailty measures reported all important model performance measures. When comparing the predictive value of frailty measures with existing models, few studies reported if the frailty measurement was separately performed from the existing perioperative risk assessment.
CONCLUSIONS:
The addition of frailty measures to the existing perioperative risk models improved the prediction performance for mortality, but the incorporation of frailty assessment into the perioperative risk assessment needs further evidence before making health policy recommendations. This article is protected by copyright. All rights reserved.A
