Postoperative Complications Among Frail Older ICU Patients: A Scoping Review

Abstract

OBJECTIVES: To map the types and incidences of postoperative complications reported among frail adults (≥65 y) during intensive care treatment. METHODS: A scoping review conducted following the Joanna Briggs Institute (JBI) methodological guidance and reported following the PRISMA-ScR guidelines. Sources of evidence included Medline (through PubMed), CINAHL (through EBSCO), and the Cochrane Library. Eligible studies enrolled postoperative patients aged 65 years or older who were identified as frail using validated assessment tools.Two reviewers performed 2-stage screening and standardized data charting. Outcomes were categorized by organ system, mortality, length of hospital and intensive care stay, and readmission. RESULTS: Of 1345 titles, 8 observational studies were included. Reporting of postoperative complications in frail cohorts was heterogeneous. Described events included acute kidney injury, atrial fibrillation, pneumonia, delirium, and infectious complications. Mortality and lengths of stay were frequently reported but definitions and time points varied. CONCLUSIONS: Evidence describing postoperative complications among frail older adults requiring intensive care remains limited and inconsistent. Standardized definitions and systematic reporting of complications in frail populations are needed to improve comparability and support evidence-based care planning for this vulnerable group.