Annals of Vascular Surgery · Jun 17, 2025

Role of Frailty in Predicting Outcomes After Surgical Repair of Abdominal Aortic Aneurysm: A Systematic Review and Meta-Analysis

By Xu F, Mo J, Chen X

BACKGROUND: We aimed to generate high-quality pooled data to examine the effect of frailty on outcomes after surgical repair of abdominal aortic aneurysm (AAA). METHODS: We undertook a literature search on PubMed, Embase, Scopus, and Web of Science databases up to January 25, 2025, for cohort studies reporting the impact of frailty on adverse outcomes after surgical management of AAA. Outcomes were mortality, complications, reintervention, and nonhome discharge. Both short-term (in-hospital and 30 days) and long-term (>1 year) mortality were assessed. RESULTS: Thirteen articles were eligible. Meta-analysis showed that frailty was a statistically significant predictor of short-term (odds ratio [OR]: 2.72 95% confidence interval [CI]: 1.91, 3.89 I² = 73%) and long-term mortality (OR: 2.42 95% CI: 1.65, 3.53 I² = 90%) after operative treatment of AAA. Subgroup analysis based on the type of repair (open/endovascular), location, frailty scale, and follow-up did not alter the results. Meta-regression failed to demonstrate a significant impact of the percentage of frail patients on mortality outcomes. Pooled results also showed that frailty was significantly associated with a higher risk of complications (OR: 2.18 95% CI: 1.52, 3.12 I² = 95%), reintervention (OR: 1.36 95% CI: 1.10, 1.68 I² = 44%) and nonhome discharge (OR: 3.46 95% CI: 1.55, 7.72 I² = 99%) after AAA repair. CONCLUSION: Frailty seems to be a predictor of adverse outcomes after surgical treatment of AAA. The presence of frailty may increase the risk of mortality, complications, reintervention, and nonhome discharge.

doi.org/10.1016/j.avsg.2025.06.010PubMed 40553839Populations