The Current Status of Frailty and Influencing Factors in Elderly Patients With Hip Fractures: A Meta-Analysis.

Background

Hip fractures have emerged as a significant health risk, posing a substantial threat to the well-being and longevity of the elderly population. The occurrence of postoperative complications and frailty profoundly impacts the quality of life in these individuals. This meta-analysis is aimed at elucidating the present scenario and clarifying the current status and influencing factors of frailty in elderly hip fracture patients. The findings will serve as a solid evidence for formulating effective and scientific strategies to prevent frailty in this vulnerable patient group.

Methods

The databases, including PubMed, Cochrane Library, and Embase, were utilized from February 2003 to February 2023, using the keywords frailty, elderly, and hip fractures to identify systematic reviews or meta-analyses. The primary randomized clinical trials included in systematic reviews or meta-analyses were identified. Two independent authors assessed the quality of all eligible studies. Statistical analyses were evaluated using Review Manager (RevMan) Version 5.3.

Results

Of the 15 studies out of 352 identified studies, 12 cross-sectional research studies, 2 case-control studies, and 1 cohort study were confirmed. There were 3475 hip fracture patients, 1209 of them showed frailty, with a 41% incidence of frailty, and 18 influence factors were determined. A marked between-study heterogeneity (I 2 = 95%, p < 0.00001) was examined. Factors influencing frailty in elderly hip fracture patients were identified including age (odds ratio (OR) = 2.73, 95% confidence interval (CI): 2.12~3.53), comorbidity (OR = 4.20, 95% CI: 2.31~7.62), duration of bed rest (OR = 2.22, 95% CI: 1.54~3.18), nutritional status (OR = 1.62, 95% CI: 1.21~2.17), and self-perceived health status (OR = 3.53, 95% CI: 2.09~5.94). There was no publication bias, and the pooled results were stable basing on sensitivity analysis.

Conclusion

Frailty in elderly hip fracture patients is associated with a variety of factors consisting of age, comorbidity conditions, extended periods of bed rest, nutritional status, high comorbid conditions, poor self-perceived health status, advanced age, and poor nutritional status.