7
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Prognostic Value of Frailty for Older Patients with Heart Failure: A Systematic Review and Meta-Analysis of Prospective Studies

      review-article
      , , , , ,
      BioMed Research International
      Hindawi

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Objective

          Numerous studies have investigated the prognostic role of frailty in elderly patients with heart failure (HF), but the limited size of the reported studies has resulted in continued uncertainty regarding its prognostic impact. The aim of this study was to integrate the findings of all available studies and estimate the impact of frailty on the prognosis of HF by performing a systematic review and meta-analysis.

          Methods

          PubMed, Embase, Cochrane, and Web of Science databases were searched from inception to November 8 th 2017 to identify eligible prospective studies. The Newcastle-Ottawa Scale (NOS) was used to evaluate study quality. The association between frailty and HF outcomes was reviewed. Overall hazard ratios (HRs) for the effects of frailty on all-cause mortality were pooled using a fixed-effect model and publication bias was evaluated using funnel plots.

          Results

          A total of 10 studies involving 3033 elderly patients with HF were included in the systematic review and meta-analysis. All eligible studies indicated that frailty was of prognostic significance for HF patients. The HRs for the effects of frailty on all-cause mortality were 1.70 (95% confidence interval (CI): 1.41–2.04), based on the pooling of six studies that provided related data. However, publication bias was observed among the studies.

          Conclusions

          Frailty has a high prevalence among older patients with HF. Elderly HF patients with frailty have a poorer prognosis than those without frailty. Further studies are now required to implement the use of frailty assessment tools and explore effective interventions for frailty in older HF patients.

          Related collections

          Most cited references32

          • Record: found
          • Abstract: found
          • Article: not found

          Prevalence and prognostic impact of frailty and its components in non-dependent elderly patients with heart failure.

          The aim of this study was to evaluate the prevalence, clinical features, and the independent impact of frailty-a geriatric syndrome characterized by the decline of physiological systems-and its components, on prognosis after heart failure (HF) hospitalization.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Frailty and risk for heart failure in older adults: the health, aging, and body composition study.

            The aim of this study was to assess the association between frailty and risk for heart failure (HF) in older adults.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Frailty predicts long-term mortality in elderly subjects with chronic heart failure.

              The elderly are characterized by a high prevalence of chronic heart failure (CHF) and frailty, which is a complex interaction of physical, psychological and social impairment. This study aimed to examine the predictive role of frailty on long-term mortality in elderly subjects with CHF. The study assessed long-term mortality after 12-year follow up in 120 subjects with CHF and 1139 subjects without CHF, selected in 1992, from a random sample of the elderly population in the Campania region of Italy. Frailty was assessed according to a 'Frailty Staging System'. Subjects with CHF were prevalently female (60%) and older than 75 years (mean 75.9 +/- 6.7); subjects without CHF were prevalently female (56.4%) and younger than 75 years (mean 74.0 +/- 6.3). In subjects with and without CHF stratified into classes of frailty there was a statistically significant increase in age, comorbidity, disability and low social support, and a decrease in MMSE score. Moreover, death progressively increased more with frailty in subjects (70.0% to 94.4%, P < 0.03) than in those without (43.8.% to 88.3%, P < 0.0001) CHF. The Kaplan-Meier analysis shows that at 9 years the probability of survival progressively decreased as frailty increased (45.5% to 0%) in subjects with CHF and from 62.8% to 25.9% in subjects without CHF. The Cox regression analysis indicated that frailty is predictive of mortality in the multivariate model adjusted for several variables including sex and age in subjects with and without CHF. Moreover, the analysis showed that frailty is more predictive of mortality in elderly subjects with CHF when it was analyzed either as continuous (1.48 vs. 1.36) or as a dummy (3 vs. 1 = 1.62 vs. 1.24) variable. Thus mortality among elderly subjects with or without CHF increases with frailty. Moreover, frailty is more predictive of long-term mortality in elderly subjects with than in those without CHF. Hence, frailty represents a new independent variable for predicting long-term mortality in elderly subjects with CHF.
                Bookmark

                Author and article information

                Contributors
                Journal
                Biomed Res Int
                Biomed Res Int
                BMRI
                BioMed Research International
                Hindawi
                2314-6133
                2314-6141
                2018
                22 October 2018
                : 2018
                : 8739058
                Affiliations
                School of Nursing, Jilin University, 965 Xinjiang Street, Changchun, Jilin 130020, China
                Author notes

                Academic Editor: Hiroyuki Shimada

                Author information
                http://orcid.org/0000-0002-7860-116X
                http://orcid.org/0000-0001-9072-646X
                http://orcid.org/0000-0002-1698-3545
                http://orcid.org/0000-0001-7423-8730
                Article
                10.1155/2018/8739058
                6217893
                30426017
                a5e6b531-4386-4c8c-af2b-d1befc676014
                Copyright © 2018 Xige Wang et al.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 10 July 2018
                : 13 September 2018
                : 9 October 2018
                Categories
                Review Article

                Comments

                Comment on this article