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.