Impact of frailty on postoperative outcomes after hepatectomy:A systematic review and meta-analysis

BACKGROUND The impact of frailty on postoperative outcomes in patients undergoing hepatectomy is still unclear.AIM To study the influence of frailty on postoperative outcomes,such as mortality,rate of complications,and length of hospitalization,following hepatectomy.METHODS PubMed,EMBASE,and Scopus databases were searched for observational studies with adult(≥18 years)patients after planned/elective hepatectomy.A randomeffects model was used for all analyses,and the results are expressed as weighted mean difference(WMD),relative risk(RR),or hazards ratio(HR)with 95%confidence interval(CI).RESULTS Analysis of the 13 included studies showed a significant association of frailty with elevated risk of in-hospital mortality(RR=2.76,95%CI:2.10-3.64),mortality at 30 d(RR=4.60,95%CI:1.85-11.40),and mortality at 90 d(RR=2.52,95%CI:1.70-3.75)in the postoperative period.Frail patients had a poorer long-term survival(HR=2.89,95%CI:1.84-4.53)and higher incidence of“any”complications(RR=1.69,95%CI:1.40-2.03)and major(grade III or higher on the Clavien-Dindo scale)complications(RR=2.69,95%CI:1.85-3.92).Frailty was correlated with markedly lengthier hospital stay(WMD=3.65,95%CI:1.45-5.85).CONCLUSION Frailty correlates with elevated risks of mortality,complications,and prolonged hospitalization,which need to be considered in surgical management.Further research is essential to formulate strategies for improved outcomes in this vulnerable cohort.

Enhancing pediatric asthma management through multifaceted health education

BACKGROUND Pediatric asthma is a significant public health issue that impacts the quality of life of children globally.Traditional management approaches focus on symptom control and medication adherence but often overlook the comprehensive educational needs of patients and their families.A multifaceted health education approach may offer a more holistic strategy in managing pediatric asthma,especially in outpatient settings.AIM To evaluate the efficacy of a comprehensive health education strategy in improving disease management,medication adherence,and quality of life among children with asthma in outpatient settings.METHODS In total,100 pediatric patients with severe asthma were enrolled from January 2021 to November 2022 and randomly allocated to a control group(n=50)or an observation group(n=50).The control group received standard nursing care,including basic nursing interventions and health education upon admission.In contrast,the observation group was exposed to a broad spectrum of health education methodologies,including internet-based hospital systems,social media channels,one-on-one verbal education,informational brochures,slide present ations,telephone check-ins,animated videos,and illustrated health education manuals.Data on asthma management knowledge,symptom control,quality of life[St.George’s Respiratory Questionnaire(SGRQ)],treatment adherence,and nursing satisfaction were collected and analyzed.RESULTS The scores of the observation group in knowledge areas,such as medication,home care,disease understanding,symptom management,prevention strategies,and nutritional guidance,were significantly higher than those of the control group(P<0.05).In addition,the observation group exhibited greater symptom control,improved quality of life based on their SGRQ scores,and higher treatment adherence post-intervention(P<0.05).Nursing satisfaction was also rated higher in the observation group across all evaluated areas(P<0.05).CONCLUSION Implementing a diversified health education approach in pediatric asthma management significantly enhances disease understanding,symptom management,and treatment adherence,leading to improved quality of life for affected children.These findings underscore the importance of multifaceted clinical health education in augmenting disease awareness and facilitating continuous improvements in asthma control rates,highlighting the potential benefits of incorporating comprehensive educational strategies into pediatric asthma care protocols.