Risk stratification in orthopedic frailty: mini-review of recent results of indices used and meta-scientific implications
Estratificación del riesgo en fragilidad ortopédica: una mini-revisión
DOI:
https://doi.org/10.33936/qkrcs.v9i2.7623Keywords:
Prediction algorithms, professional practice gaps, frailty, Orthopedics, traumatologyAbstract
Frailty has emerged as a critical determinant of perioperative risk in orthopedic surgery due to its ability to reflect the multidimensional vulnerability of older adults. However, the wide range of available indices and the methodological heterogeneity in their application have hindered the standardization of their clinical use. The aim of this mini-review was to synthesize the most recent evidence on frailty-based risk stratification in orthopedic surgery and to highlight the strengths and weaknesses of the most commonly used indices, framing the discussion from a meta-scientific and evidence-based medicine perspective regarding the applicability of these tools. An exploratory search was conducted in PubMed, Scopus, and Web of Science, prioritizing meta-analyses, systematic reviews, and relevant original studies, and reporting their findings as originally published. The synthesis focused on assessing predictive validity, evaluated domains, and methodological limitations of the main indices used in orthopedic practice. The results show that frailty consistently predicts postoperative mortality and complications with moderate to high validity, although substantial conceptual and methodological gaps persist. The evidence supports incorporating frailty assessment into the orthopedic clinical workflow; however, its implementation requires standardization, comparative validation, and a more rigorous meta-scientific approach.
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Copyright (c) 2025 Ivan Dario Simanca Simancas, Mateo Alejandro Ruiz Florez , Sebastián Barragán Barreto , Keyla Patricia Lara Moreno, Yelson Picón Jaimes
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