A systematic review and meta-analysis of frailty in patients with heart failure.

IF 2.1 4区医学 Q3 HEALTH CARE SCIENCES & SERVICES Journal of evaluation in clinical practice Pub Date : 2024-10-23 DOI:10.1111/jep.14192

Xia Chen, Xiangying Meng

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Abstract

Objective: To systematically evaluate the effect of frailty on the prognosis of patients with heart failure.

Methods: Computer searches were conducted on PubMed, Embase, The Cochrane Library, Web of Science, CNKI, Wanfang Data Knowledge Service platform, Weipu full-text database of Chinese scientific and technological journals, and Chinese biomedical literature database from August 12, 2022. After literature screening was completed by two researchers, the data extraction (such as study type, sample size, age of included patients, New York Heart Association (NYHA) Functional Classification, frailty assessment tool, frailty positive rate, outcome indicators, etc.) was performed and the risk of bias in the included studies was assessed. Meta-analysis was performed using Revman 5.4 and Stata 14.0 software.

Results: A total of 32 studies were included, including 406,269 patients with heart failure. All included studies were rated high overall quality. The results of meta-analysis showed: Frailty increases the risk of all-cause death in patients with heart failure (hazard ratio [HR] = 1.73, 95% confidence interval [CI]: 1.50 - 2.00, p < 0.001), unplanned readmission (HR = 1.96, 95% CI: 1.21 - 3.17, p = 0.006), and joint endpoint risk (HR = 1.66, 95% CI: 1.48 - 1.86, p < 0.001).

Conclusion: Current evidence suggests that frailty increases the risk of all-cause death, unplanned readmission, and joint endpoints in patients with heart failure.

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心力衰竭患者虚弱程度的系统回顾和荟萃分析。

目的：系统评估虚弱对心力衰竭患者预后的影响：系统评估虚弱对心力衰竭患者预后的影响：自2022年8月12日起，在PubMed、Embase、The Cochrane Library、Web of Science、CNKI、万方数据知识服务平台、维普中文科技期刊全文数据库、中国生物医学文献数据库等数据库中进行计算机检索。由两名研究人员完成文献筛选后，进行数据提取（如研究类型、样本量、纳入患者年龄、纽约心脏病协会（NYHA）功能分级、虚弱评估工具、虚弱阳性率、结局指标等），并评估纳入研究的偏倚风险。使用 Revman 5.4 和 Stata 14.0 软件进行了 Meta 分析：结果：共纳入 32 项研究，包括 406269 名心衰患者。所有纳入研究的总体质量都很高。荟萃分析结果显示虚弱会增加心衰患者全因死亡的风险（危险比 [HR] = 1.73，95% 置信区间 [CI]：1.50 - 2.00，P 结论：目前的证据表明，虚弱会增加心衰患者全因死亡、非计划再入院和联合终点的风险。

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来源期刊

Journal of evaluation in clinical practice 医学-卫生保健

CiteScore

4.80

自引率

4.20%

发文量

143

审稿时长

3-8 weeks

期刊介绍： The Journal of Evaluation in Clinical Practice aims to promote the evaluation and development of clinical practice across medicine, nursing and the allied health professions. All aspects of health services research and public health policy analysis and debate are of interest to the Journal whether studied from a population-based or individual patient-centred perspective. Of particular interest to the Journal are submissions on all aspects of clinical effectiveness and efficiency including evidence-based medicine, clinical practice guidelines, clinical decision making, clinical services organisation, implementation and delivery, health economic evaluation, health process and outcome measurement and new or improved methods (conceptual and statistical) for systematic inquiry into clinical practice. Papers may take a classical quantitative or qualitative approach to investigation (or may utilise both techniques) or may take the form of learned essays, structured/systematic reviews and critiques.