Abstract
Objective
Frailty is a known risk factor for adverse outcomes after cardiac interventions. However,
the extent to which it increases the likelihood of adverse outcomes in heart failure
(HF) patients remains unexplored. Therefore, we conducted this systematic review and
meta-analysis to quantify the impact of frailty on prognosis in this patient population.
Design
Meta-analysis.
Setting and Participants
PubMed and Embase were searched for studies that investigated the relationship between
frailty and outcomes in patients with HF. The search period was from the beginning
of the databases through to December 3, 2017.
Measures
A total of 342 and 919 entries were retrieved from PubMed and Embase, respectively.
Of these, 20 met our inclusion criteria and were therefore included.
Results
Frailty significantly increased the risk of all-cause mortality [hazard ratio (HR) = 1.59,
95% confidence interval (CI) = 1.39-1.82, P < .0001, I2 = 55%] and hospitalizations (HR = 1.31, 95% CI = 1.21-1.42, P < .0001, I2 = 0%). Moreover, it was predictive of all-cause mortality after ventricular assist
device implantation for advanced HF (HR = 1.62, 95% CI = 1.35-1.94, P < .0001, I2 = 2%).
Conclusions/Implications: Frailty is a significant predictor of all-cause mortality
and hospital readmissions in HF. Assessment and close monitoring of frailty status
of heart failure patients can potentially better guide clinical management of this
population.
Keywords
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Article info
Publication history
Published online: August 01, 2018
Footnotes
This work was supported by grants (30900618, 81270245, 81570298 to T.L.) from the National Natural Science Foundation of China, Tianjin Natural Science Foundation (16JCZDJC34900 to T.L.) and Croucher Foundation of Hong Kong (Clinical Assistant Professorship to G.T.).
The authors declare no conflicts of interest.
Y. Zhang and M. Yuan are co–first authors.
Identification
Copyright
© 2018 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
