Frailty and the risk of all‐cause mortality and hospitalization in chronic heart failure: a meta‐analysis

ESC Heart Failure

Cristiana Vitale¹  Stanisław Manulik²  Izabella Uchmanowicz²  Joanna Jaroch²  Ewa A. Jankowska²  Bartosz Uchmanowicz²  Joanna Rosińczuk²  Marcin Drozd²  Quin E. Denfeld³  Christopher S. Lee⁴ 

[1] Centre for Clinical and Basic Research, IRCCS San Raffaele Pisana Rome Italy;Department of Clinical Nursing, Faculty of Health Sciences Wroclaw Medical University Bartla 5 Wroclaw 51‐618 Poland;Oregon Health and Science University School of Nursing Portland OR USA;William F. Connell School of Nursing Boston College Boston MA USA;

关键词: Heart failure;    Frailty;    Fried's phenotype;    Mortality;    Hospitalization;    Meta‐analysis;   

DOI  :  10.1002/ehf2.12827

来源: DOAJ

【 摘 要 】

Abstract To estimate the risk of all‐cause mortality and hospitalization in frail patients with chronic heart failure (HF), a systematic search and meta‐analysis was carried out to identify all prospective cohort studies conducted among adults with HF where frailty was quantified and related to the primary endpoints of all‐cause mortality and/or hospitalization. Twenty‐nine studies reporting the link between frailty and all‐cause mortality in 18 757 patients were available for the meta‐analysis, along with 11 studies, with 13 525 patients, reporting the association between frailty and hospitalization. Frailty was a predictor of all‐cause mortality and hospitalization with summary hazard ratios (HRs) of 1.48 [95% confidence interval (CI): 1.31–1.65, P < 0.001] and 1.40 (95% CI: 1.27–1.54, P < 0.001), respectively. Summary HRs for all‐cause mortality among frail inpatients undergoing ventricular assist device implantation, inpatients hospitalized for HF, and outpatients were 1.46 (95% CI: 1.18–1.73, P < 0.001), 1.58 (95% CI: 0.94–2.22, P = not significant), and 1.53 (95% CI: 1.28–1.78, P < 0.001), respectively. Summary HRs for all‐cause mortality and frailty based on Fried's phenotype were 1.48 (95% CI: 1.03–1.93, P < 0.001) and 1.42 (95% CI: 1.05–1.79, P < 0.001) for inpatients and outpatients, respectively, and based on other frailty measures were 1.42 (95% CI: 1.12–1.72, P < 0.001) and 1.60 (95% CI: 1.43–1.77, P < 0.001) for inpatients and outpatients, respectively. Across clinical contexts, frailty in chronic HF is associated with an average of 48% and 40% increase in the hazard of all‐cause mortality and hospitalization, respectively. The relationship between frailty and all‐cause mortality is similar across clinical settings and comparing measurement using Fried's phenotype or other measures.

【 授权许可】

Unknown