ABSTRACT
Background: There is emerging evidence that frail individuals present a decreased physiological reserve, de-creased ability to maintain homeostasis, and increased vulnerability to stressors. The concept of frailty has be-come increasingly recognized as a valuable measure in oncological surgical patients, including those with headand neck cancer. Preoperative screening for frailty may provide an individualized risk assessment that can be usedby an interdisciplinary team for preoperative counseling and to improve outcomes. The aim of this meta-analysiswas to evaluate the relationship between frailty and the risk of major postoperative complications in frail individu-als submitted to head and neck oncologic surgery.Material and Methods: PubMed, SCOPUS, Web of Science, Google Scholar and OpenThesis were systematicallysearched to identify studies that evaluated the risk of major postoperative complications in frail individuals under-going head and neck oncologic surgery. The search was performed on August 31, 2020, without language or daterestrictions. Two independent investigators screened the searched studies based on each papers title and abstract.Relevant studies were read in full and selected according to the eligibility criteria. Frailty was assessed by modi-fied Frailty Index (mFI-11) and major postoperative complications were measured by the Clavien-Dindo classifica-tion. We performed a categorical and dose-response meta-analysis using a random-effects model to evaluate theassociation between frailty and the risk of major postoperative complications in patients submitted to head andneck oncologic surgery. The results of the meta-analysis were expressed as relative risk (RR) and 95% confidenceinterval (95% CI). The risk of bias was assessed using the Newcastle-Ottawa Scale (NOS). Results: Four studies (9,947 patients) were included in this systematic...(AU)
