{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T23:35:42Z","timestamp":1793144142930,"version":"4.5.0"},"reference-count":68,"publisher":"Public Library of Science (PLoS)","issue":"6","license":[{"start":{"date-parts":[[2024,6,21]],"date-time":"2024-06-21T00:00:00Z","timestamp":1718928000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"the Health Commission of Hebei Province of China","award":["No. 20201744"],"award-info":[{"award-number":["No. 20201744"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Some studies have associated frailty and prognostic outcomes in geriatric hip fracture patients, but whether frailty can predict postoperative outcomes remains controversial. This review aims to assess the relationship between frailty and adverse postoperative outcomes in geriatric patients with hip fracture.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Based on electronic databases, including PubMed, Embase, Web of Science, Cumulative Index to Nursing and Allied Health Literature, the Cochrane Library, Chinese National Knowledge Infrastructure, and WanFang Data, we systematically searched for studies that investigated the association between frailty and adverse outcomes among patients aged 60 or over after hip fracture surgery. Stata 17.0 and Trial Sequential Analysis viewer software were used to obtain pooled estimates and verify whether the sample size was sufficient and the evidence robust.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twenty-one studies involving 49,196 patients were included for quantitative analysis. Compared with nonfrail patients, frail patients had a higher risk of inpatient mortality (risk ratio [RR] = 1.93, 95% confidence interval [CI]: 1.66\u20132.23), 30-day mortality (RR = 2.13, 95% CI: 1.23\u20133.70), and 1-year mortality (RR = 2.44, 95% CI: 1.47\u20134.04). Frailty can significantly predict postoperative complications (RR = 1.76, 95% CI: 1.38\u20132.23), including delirium, pneumonia, cardiac complications, urinary tract infection, and surgical site infection; the association between frailty and deep venous thrombosis\/pulmonary embolism and acute kidney injury needs further analysis. Trial sequential analysis showed that the findings regarding mortality were reliable and robust.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This meta-analysis provides detailed information indicating that frailty is a substantial predictor of mortality and selected postoperative complications.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0305706","type":"journal-article","created":{"date-parts":[[2024,6,21]],"date-time":"2024-06-21T13:48:22Z","timestamp":1718977702000},"page":"e0305706","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":21,"title":["Association of frailty with adverse outcomes in surgically treated geriatric patients with hip fracture: A meta-analysis and trial sequential analysis"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4415-9182","authenticated-orcid":true,"given":"Xiaomeng","family":"Dong","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2727-2711","authenticated-orcid":true,"given":"Xiuguo","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fang","family":"Hu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuhong","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zengchao","family":"Hong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qian","family":"Geng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2024,6,21]]},"reference":[{"issue":"12","key":"pone.0305706.ref001","doi-asserted-by":"crossref","first-page":"2939","DOI":"10.1007\/s00264-022-05605-9","article-title":"Prognostic significance of frailty in older patients with hip fracture: a systematic review and meta-analysis.","volume":"46","author":"B Yan","year":"2022","journal-title":"Int Orthop"},{"issue":"8","key":"pone.0305706.ref002","doi-asserted-by":"crossref","first-page":"1064","DOI":"10.1002\/jbmr.4821","article-title":"Global Epidemiology of Hip Fractures: Secular Trends in Incidence Rate, Post-Fracture Treatment, and All-Cause Mortality","volume":"38","author":"CW Sing","year":"2023","journal-title":"J Bone Miner Res"},{"issue":"10","key":"pone.0305706.ref003","doi-asserted-by":"crossref","first-page":"2174","DOI":"10.1016\/j.injury.2017.08.001","article-title":"Using national hip fracture registries and audit databases to develop an international perspective.","volume":"48","author":"A Johansen","year":"2017","journal-title":"Injury."},{"issue":"49","key":"pone.0305706.ref004","doi-asserted-by":"crossref","first-page":"e18220","DOI":"10.1097\/MD.0000000000018220","article-title":"Perioperative outcomes in geriatric patients undergoing hip fracture surgery with different anesthesia techniques: A systematic review and meta-analysis","volume":"98","author":"DX Chen","year":"2019","journal-title":"Medicine (Baltimore)."},{"issue":"1","key":"pone.0305706.ref005","doi-asserted-by":"crossref","first-page":"844","DOI":"10.1186\/s12877-022-03484-8","article-title":"Association between changes in depressive symptoms and hip fracture among middle-aged and older Chinese individuals: a prospective cohort study.","volume":"22","author":"Z Lian","year":"2022","journal-title":"BMC Geriatr"},{"key":"pone.0305706.ref006","first-page":"1017","article-title":"Epidemiology and management of osteoporosis in the People\u2019s Republic of China: current perspectives.","volume":"10","author":"X Lin","year":"2015","journal-title":"Clin Interv Aging"},{"key":"pone.0305706.ref007","unstructured":"National Bureau of Statistics of China [Internet]. China: China Statistical Yearbook 2021 [cited 2024 Jan 24]. Available from: https:\/\/ghdx.healthdata.org\/record\/china-statistical-yearbook-2021."},{"issue":"2","key":"pone.0305706.ref008","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1093\/ageing\/afr182","article-title":"Frailty in the older surgical patient: a review.","volume":"41","author":"JS Partridge","year":"2012","journal-title":"Age Ageing."},{"issue":"6","key":"pone.0305706.ref009","doi-asserted-by":"crossref","first-page":"780","DOI":"10.1016\/j.jamda.2020.03.008","article-title":"The Association between Frailty and Healthcare Expenditure among Chinese Older Adults.","volume":"21","author":"HY Jin","year":"2020","journal-title":"J Am Med Dir Assoc"},{"key":"pone.0305706.ref010","doi-asserted-by":"crossref","first-page":"456","DOI":"10.1016\/j.jss.2020.05.090","article-title":"The 5 and 11 Factor Modified Frailty Indices are Equally Effective at Outcome Prediction Using TQIP","volume":"255","author":"BM Tracy","year":"2020","journal-title":"J Surg Res"},{"issue":"8","key":"pone.0305706.ref011","doi-asserted-by":"crossref","first-page":"1398","DOI":"10.1016\/j.injury.2018.04.014","article-title":"Orthogeriatric co-management\u2014managing frailty as well as fragility.","volume":"49","author":"G Pioli","year":"2018","journal-title":"Injury."},{"issue":"Suppl 1","key":"pone.0305706.ref012","first-page":"S171","article-title":"Frailty in hip fracture patients and its impact on the length of stay. 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Pizzonia","year":"2021","journal-title":"Eur J Clin Invest"},{"issue":"1","key":"pone.0305706.ref040","article-title":"The association between preoperative modified frailty index and postoperative complications in Chinese elderly patients with hip fractures.","volume":"21","author":"YJ Shen","year":"2021","journal-title":"BMC Geriatrics."},{"issue":"3","key":"pone.0305706.ref041","doi-asserted-by":"crossref","first-page":"494","DOI":"10.1007\/s00774-020-01187-x","article-title":"Performance of the Nottingham Hip Fracture Score and Clinical Frailty Scale as predictors of short and long-term outcomes: a dual-centre 3-year observational study of hip fracture patients","volume":"39","author":"G Thorne","year":"2021","journal-title":"J Bone Miner Metab"},{"key":"pone.0305706.ref042","first-page":"98","author":"A Shimizu","year":"2022","journal-title":"Hospital Frailty Risk Score predicts adverse events in older patients with hip fractures after surgery: Analysis of a nationwide inpatient 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Thesis, Nanchang University. 2020."},{"issue":"10","key":"pone.0305706.ref048","first-page":"962","article-title":"Predictive value of Frail Scale and CHS index on postoperative outcomes in elderly patients with hip fracture.","volume":"36","author":"S Zhu","year":"2020","journal-title":"J Cli Anes"},{"issue":"9\u201310","key":"pone.0305706.ref049","doi-asserted-by":"crossref","first-page":"1149","DOI":"10.1111\/jocn.16035","article-title":"Frailty measurements in hospitalised orthopaedic populations age 65 and older: A scoping review.","volume":"31","author":"I Roopsawang","year":"2022","journal-title":"J Clin Nurs"},{"issue":"1","key":"pone.0305706.ref050","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1186\/s12877-017-0423-6","article-title":"Prevalence of frailty in Canadians 18\u201379 years old in the Canadian Health Measures Survey.","volume":"17","author":"DS Kehler","year":"2017","journal-title":"BMC 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