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

Frailty Fried's phenotype Heart failure Hospitalization Meta-analysis Mortality

Journal

ESC heart failure
ISSN: 2055-5822
Titre abrégé: ESC Heart Fail
Pays: England
ID NLM: 101669191

Informations de publication

Date de publication:
Dec 2020
Historique:
revised: 10 05 2020
received: 03 01 2020
accepted: 21 05 2020
pubmed: 22 9 2020
medline: 22 9 2020
entrez: 21 9 2020
Statut: ppublish

Résumé

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.

Identifiants

pubmed: 32955168
doi: 10.1002/ehf2.12827
pmc: PMC7754732
doi:

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

3427-3437

Subventions

Organisme : Wroclaw Medical University
ID : SUB.E020.19.003
Organisme : Ministry of Science and Higher Education

Informations de copyright

© 2020 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of the European Society of Cardiology.

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Auteurs

Izabella Uchmanowicz (I)

Department of Clinical Nursing, Faculty of Health Sciences, Wroclaw Medical University, Bartla 5, Wroclaw, 51-618, Poland.

Christopher S Lee (CS)

William F. Connell School of Nursing, Boston College, Boston, MA, USA.

Cristiana Vitale (C)

Centre for Clinical and Basic Research, IRCCS San Raffaele Pisana, Rome, Italy.

Stanisław Manulik (S)

Department of Clinical Nursing, Faculty of Health Sciences, Wroclaw Medical University, Bartla 5, Wroclaw, 51-618, Poland.

Quin E Denfeld (QE)

Oregon Health and Science University School of Nursing, Portland, OR, USA.

Bartosz Uchmanowicz (B)

Department of Clinical Nursing, Faculty of Health Sciences, Wroclaw Medical University, Bartla 5, Wroclaw, 51-618, Poland.

Joanna Rosińczuk (J)

Department of Clinical Nursing, Faculty of Health Sciences, Wroclaw Medical University, Bartla 5, Wroclaw, 51-618, Poland.

Marcin Drozd (M)

Department of Clinical Nursing, Faculty of Health Sciences, Wroclaw Medical University, Bartla 5, Wroclaw, 51-618, Poland.
Centre for Heart Diseases, Wroclaw Medical University, Wroclaw, Poland.

Joanna Jaroch (J)

Department of Clinical Nursing, Faculty of Health Sciences, Wroclaw Medical University, Bartla 5, Wroclaw, 51-618, Poland.

Ewa A Jankowska (EA)

Department of Clinical Nursing, Faculty of Health Sciences, Wroclaw Medical University, Bartla 5, Wroclaw, 51-618, Poland.
Centre for Heart Diseases, Wroclaw Medical University, Wroclaw, Poland.

Classifications MeSH