Impact of Frailty on Mortality and Hospitalization in Chronic Heart Failure: A Systematic Review and Meta-Analysis
Por:
Yang, XB, Lupon, J, Vidan, MT, Ferguson, C, Gastelurrutia, P, Newton, PJ, Macdonald, PS, Bueno, H, Bayes-Genis, A, Woo, J and Fung, E
Publicada:
4 dic 2018
Categoría:
Cardiology and cardiovascular medicine
Resumen:
Background-Although frailty has been associated with increased risks for hospitalization and mortality in chronic heart failure, the precise average effect remains uncertain. We performed a systematic review and meta-analysis to summarize the hazards for mortality and incident hospitalization in patients with heart failure and frailty compared with those without frailty and explored the heterogeneity underlying the effect size estimates.
Methods and Results-MEDLINE, EMBASE, and Cochrane databases were queried for articles published between January 1966 and March 2018. Predefined selection criteria were used. Hazard ratios (HRs) were pooled for meta-analyses, and where odds ratios were used previously, original data were recalculated for HR. Overlapping data were consolidated, and only unique data points were used. Study quality and bias were assessed. Eight studies were included for mortality (2645 patients), and 6 studies were included for incident hospitalization (2541 patients) during a median follow-up of 1.82 and 1.12 years, respectively. Frailty was significantly associated with an increased hazard for mortality (HR, 1.54; 95% confidence interval, 1.34-1.75; P<0.001) and incident hospitalization (HR, 1.56; 95% confidence interval, 1.36-1.78; P<0.001) in chronic heart failure. The Fried phenotype estimated a 16.9% larger effect size than the combined Fried/non-Fried frailty assessment for the end point of mortality (HR, 1.80; 95% confidence interval, 1.41-2.28; P<0.001), but not for hospitalization (HR, 1.57; 95% confidence interval, 1.30-1.89; P<0.001). Study heterogeneity was found to be low (I-2=0%), and high quality of studies was verified by the Newcastle-Ottawa scale.
Conclusions-Overall, the presence of frailty in chronic heart failure is associated with an increased hazard for death and hospitalization by approximate to 1.5-fold.
Filiaciones:
Yang, XB:
Chinese Univ Hong Kong, Dept Med & Therapeut, Hong Kong, Peoples R China
Prince Wales Hosp, Li Ka Shing Inst Hlth Sci, Lab Heart Failure & Circulat Res, Hong Kong, Peoples R China
:
Hosp Univ Germans Trias i Pujol, Cardiol Dept, Badalona, Spain
Univ Autonoma Barcelona, Dept Med, Barcelona, Spain
Inst Salud Carlos III, CIBERCV, Madrid, Spain
Vidan, MT:
Univ Gregorio Maranon, Dept Geriatr, Inst Invest IiSGM, Madrid, Spain
Univ Gregorio Maranon, CIBERFES Hosp Gen, Madrid, Spain
Univ Complutense Madrid, Madrid, Spain
Ferguson, C:
Western Sydney Univ, Western Sydney Nursing & Midwifery Res Ctr, Sydney, NSW, Australia
Western Sydney Local Hlth Dist, Sydney, NSW, Australia
:
Inst Salud Carlos III, CIBERCV, Madrid, Spain
Fdn Inst Invest Ciencies Salut Germans Trial i Pu, Badalona, Spain
Newton, PJ:
Western Sydney Univ, Western Sydney Nursing & Midwifery Res Ctr, Sydney, NSW, Australia
Western Sydney Local Hlth Dist, Sydney, NSW, Australia
Macdonald, PS:
Univ New South Wales, St Vincents Hosp, Heart & Lung Transplant Unit, Sydney, NSW, Australia
Victor Chang Cardiac Res Inst, Transplantat Res Lab, Sydney, NSW, Australia
Bueno, H:
Univ Complutense Madrid, Madrid, Spain
Ctr Nacl Invest Cardiovasc, Madrid, Spain
Hosp Univ 12 Octubre, Inst Invest i 12, Madrid, Spain
Hosp Univ 12 Octubre, Cardiol Dept, Madrid, Spain
:
Hosp Univ Germans Trias i Pujol, Cardiol Dept, Badalona, Spain
Univ Autonoma Barcelona, Dept Med, Barcelona, Spain
Inst Salud Carlos III, CIBERCV, Madrid, Spain
Woo, J:
Chinese Univ Hong Kong, Dept Med & Therapeut, Hong Kong, Peoples R China
Chinese Univ Hong Kong, Fac Med, Hong Kong, Peoples R China
Chinese Univ Hong Kong, CUHK Jockey Club Inst Ageing, Hong Kong, Peoples R China
Fung, E:
Chinese Univ Hong Kong, Dept Med & Therapeut, Hong Kong, Peoples R China
Chinese Univ Hong Kong, CARE Programme, Lui Che Woo Inst Innovat Med, Hong Kong, Peoples R China
Chinese Univ Hong Kong, Gerald Choa Cardiac Res Ctr, Hong Kong, Peoples R China
Prince Wales Hosp, Li Ka Shing Inst Hlth Sci, Lab Heart Failure & Circulat Res, Hong Kong, Peoples R China
Imperial Coll London, Sch Publ Hlth, London, England
Green Submitted, Green Published, gold
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