Citation

Roohollahi F, Molavi S, Mohammadi M, Mohamadi M, Mohammadi A, Kankam SB, Farahbakhsh F, Moarrefdezfouli A, Peters ME, Albrecht JS, Gardner RC, Rahimi-Movaghar V. J. Neurotrauma 2023; ePub(ePub): ePub.

Copyright

(Copyright © 2023, Mary Ann Liebert Publishers)

DOI

10.1089/neu.2023.0176

PMID

37416987

Abstract

Frailty is a known predictor of negative health outcomes. However, the role of frailty in predicting outcomes following traumatic brain injury (TBI) is unclear. This systematic review aimed to evaluate the association between frailty and adverse outcomes in TBI patients. We identified relevant articles that investigated the relationship between frailty and outcomes in TBI patients by searching PubMed/MEDLINE, Web of Science, Scopus, and EMBASE from inception until 23 March 2023. We identified 12 studies that met our inclusion criteria; three were prospective. Of included studies, eight had low risk, three had moderate risk, and one had high risk of bias. Frailty was significantly associated with mortality in 5 studies, with an increased risk of in-hospital mortality and complications observed in frail patients. Frailty was associated with longer hospital stays and unfavorable outcome measured by the Extended Glasgow Outcome Scale (GOSE) in 4 studies. The meta-analysis found that higher frailty significantly increased the odds of non-routine discharge and unfavorable outcome as measured by GOSE scores of 4 or lower. However, the analysis did not find a significant predictive role for frailty on 30-day mortality or in-hospital mortality. The pooled odds ratio (OR) for higher frailty and 30-day mortality was 2.35, with a 95% confidence interval (CI) of 0.98-5.64; for in-hospital mortality, it was 1.14, with a 95% CI of 0.73-1.78; for non-routine discharge, it was 1.80, with a 95% CI of 1.15-2.84; and for unfavorable outcome, it was 1.80, with a 95% CI of 1.15-2.84.

Language: en

Keywords

HEAD TRAUMA; TRAUMATIC BRAIN INJURY; ADULT BRAIN INJURY; GERIATRIC BRAIN INJURY