دورية أكاديمية

Frailty and risk of complications in head and neck oncologic surgery. Systematic review and dose-response meta-analysis.

التفاصيل البيبلوغرافية
العنوان: Frailty and risk of complications in head and neck oncologic surgery. Systematic review and dose-response meta-analysis.
المؤلفون: Mendes ML; Universidade Federal de Sergipe, Hospital Universitário Laboratório de Patologia Investigativa Rua Cláudio Batista, s/n. Bairro Sanatório CEP: 49060-100. Aracaju, Sergipe, Brasil saqmartins@hotmail.com., Mahl C, Carvalho AC, Santos VS, Tanajura DM, Martins-Filho PR
المصدر: Medicina oral, patologia oral y cirugia bucal [Med Oral Patol Oral Cir Bucal] 2021 Sep 01; Vol. 26 (5), pp. e582-e589. Date of Electronic Publication: 2021 Sep 01.
نوع المنشور: Journal Article; Meta-Analysis; Systematic Review
اللغة: English
بيانات الدورية: Publisher: Medicina Oral S.L Country of Publication: Spain NLM ID: 101231694 Publication Model: Electronic Cited Medium: Internet ISSN: 1698-6946 (Electronic) Linking ISSN: 16984447 NLM ISO Abbreviation: Med Oral Patol Oral Cir Bucal Subsets: MEDLINE
أسماء مطبوعة: Original Publication: Valencia, España : Medicina Oral S.L., [2004]-
مواضيع طبية MeSH: Frailty* , Head and Neck Neoplasms*/surgery, Humans ; Postoperative Complications/epidemiology ; Postoperative Complications/etiology ; Risk Assessment ; Risk Factors
مستخلص: Background: There is emerging evidence that frail individuals present a decreased physiological reserve, decreased ability to maintain homeostasis, and increased vulnerability to stressors. The concept of frailty has become increasingly recognized as a valuable measure in oncological surgical patients, including those with head and neck cancer. Preoperative screening for frailty may provide an individualized risk assessment that can be used by an interdisciplinary team for preoperative counseling and to improve outcomes. The aim of this meta-analysis was to evaluate the relationship between frailty and the risk of major postoperative complications in frail individuals submitted to head and neck oncologic surgery.
Material and Methods: PubMed, SCOPUS, Web of Science, Google Scholar and OpenThesis were systematically searched to identify studies that evaluated the risk of major postoperative complications in frail individuals undergoing head and neck oncologic surgery. The search was performed on August 31, 2020, without language or date restrictions. Two independent investigators screened the searched studies based on each paper's title and abstract. Relevant studies were read in full and selected according to the eligibility criteria. Frailty was assessed by modified Frailty Index (mFI-11) and major postoperative complications were measured by the Clavien-Dindo classification. We performed a categorical and dose-response meta-analysis using a random-effects model to evaluate the association between frailty and the risk of major postoperative complications in patients submitted to head and neck oncologic surgery. The results of the meta-analysis were expressed as relative risk (RR) and 95% confidence interval (95% CI). The risk of bias was assessed using the Newcastle-Ottawa Scale (NOS).
Results: Four studies (9,947 patients) were included in this systematic review and meta-analysis. Frail patients presented an increased risk of life-threatening complications requiring intensive care unit (ICU) admission (RR = 4.67; 95% CI 1.54-14.10) and 30-day mortality (RR = 8.10; 95% CI 2.30-28.57) compared to non-frail patients. We found evidence of dose-response trend between mFI-11 and major postoperative complications.
Conclusions: Higher frailty scores are associated with a significant increase in ICU-level complications and 30-day mortality after head and neck oncologic surgery.
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فهرسة مساهمة: Keywords: Frailty; Head and Neck Neoplasms; Postoperative Complications; Mortality.
تواريخ الأحداث: Date Created: 20210820 Date Completed: 20210831 Latest Revision: 20210910
رمز التحديث: 20231215
مُعرف محوري في PubMed: PMC8412444
DOI: 10.4317/medoral.24588
PMID: 34414998
قاعدة البيانات: MEDLINE
الوصف
تدمد:1698-6946
DOI:10.4317/medoral.24588