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Frailty Among Patients Undergoing Breast Reconstruction Surgery: A Systematic Review and Meta-Analysis Publisher Pubmed



Shafiee A1 ; Bahri RA2 ; Rafiei MA3
Authors

Source: Journal of Plastic# Reconstructive and Aesthetic Surgery Published:2023


Abstract

Background: We conducted a systematic review and meta-analysis to evaluate the predictive value of frailty for predicting postsurgical complications in patients undergoing breast reconstruction surgery. Methods: MEDLINE (PubMed), Scopus, Web of Science, and Embase were searched for relevant studies up to September 13, 2022. A systematic review and meta-analysis of studies were performed based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 statement criteria. Results: Nine studies were included in this research. The rates of overall complications (odds ratio [OR] 1.52, 95% confidence interval [CI] 1.17–1.97, I2 = 76%; p = 0.002), wound complications (OR 1.87, 95% CI 1.56–2.26, I2 = 16%; p < 0.0001), readmissions (OR 1.94, 95% CI 1.61–2.34, I2 = 15%; p < 0.0001), and reoperations (OR 1.41, 95% CI 1.12–1.77, I2 = 39%; p = 0.003) were significantly greater in frail patients than in nonfrail undergoing breast reconstruction surgery. Furthermore, compared with nonfrail patients, this difference remained significantly higher among prefrail individuals (overall complications: OR 1.27, 95% CI 1.13–1.41, I2 = 67%; p < 0.001, wound complications: OR 1.48, 95% CI 1.33–1.66, I2 = 24%; p < 0.0001, readmission: OR 1.47, 95% CI 1.34–1.61, I2 = 0%; p < 0.0001, reoperation: OR 1.32, 95% CI 1.23–1.42, I2 = 0%; p < 0.0001). We found that frail patients undergoing immediate autologous reconstruction surgery are the most vulnerable to experiencing overall postoperative complications. Conclusion: Frailty is a strong predictor of postsurgical complications after breast reconstruction surgery in frail and prefrail patients. The most frailty index utilized was the modified five-item frailty index (mFI-5). More research is needed on this topic to assess the utility of frailty in practice, especially in countries other than the United States. © 2023 British Association of Plastic, Reconstructive and Aesthetic Surgeons
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