Association of Prefrailty and Frailty With All-Cause Mortality, Acute Exacerbation, and Hospitalization in Patients With Chronic Obstructive Pulmonary Disease: A Meta-Analysis

被引:9
作者
Xu, Juan [1 ]
Xu, Wei [2 ]
Qiu, Yue [2 ]
Gong, Dandan [2 ]
Man, Changfeng [2 ]
Fan, Yu [2 ,3 ]
机构
[1] Ganyu Dist Peoples Hosp Lianyungang City, Dept Oncol, Lianyungang, Jiangsu, Peoples R China
[2] Jiangsu Univ, Affiliated Peoples Hosp, Canc Inst, Zhenjiang, Jiangsu, Peoples R China
[3] Jiangsu Univ, Affiliated Peoples Hosp, Canc Inst, 8 Dianli Rd, Zhenjiang 212002, Jiangsu, Peoples R China
关键词
Frailty; chronic obstructive pulmonary disease; all-cause mortality; hospitalization; meta-analysis; PREVALENCE; COPD; RISK;
D O I
10.1016/j.jamda.2023.03.032
中图分类号
R592 [老年病学]; C [社会科学总论];
学科分类号
03 ; 0303 ; 100203 ;
摘要
Objective: To evaluate the impact of prefrailty and frailty on all-cause mortality, acute exacerbation, and all-cause hospitalization in patients with chronic obstructive pulmonary disease (COPD).Design: Meta-analysis.Setting and Participants: Two authors independently searched PubMed, Web of Science, and Embase databases until December 27, 2022,to identify studies that reported the predictive value of prefrailty and frailty in COPD patients.Measurements: All-cause mortality, acute exacerbation, and all-cause hospitalization.Results: Ten studies reporting on 11 articles enrolling 13,203 patients with COPD were included. The prevalence of frailty ranged from 6.0% to 51%. When compared with nonfrailty, the pooled adjusted hazard ratio (HR) of all-cause mortality was 1.48 (95% CI 0.92-2.40) for prefrailty and 2.64 (95% CI 1.74-4.02) for frailty, respectively. The pooled adjusted odds ratio (OR) of all-cause hospitalization was 1.35 (95% CI 1.05-1.74) for prefrailty and 1.65 (95% CI 1.05-2.61) for frailty. In addition, frailty significantly predicted all acute exacerbation (OR 2.20, 95% CI 1.26-3.81) but not moderate to severe acute exacer-bation (OR 1.42, 95% CI 0.94-2.17) in patients with stable COPD. However, the pooled results of all-cause hospitalization were not reliable in leave-1-out sensitivity analyses.Conclusions and Implications: Frailty significantly predicts all-cause mortality in patients with COPD, even after adjustment for common confounding factors. Assessment of frail status in COPD patients may improve secondary prevention and allow early intervention. However, future studies are warranted to validate the impact of frailty defined by a standardized definition of frailty on acute exacerbation and all-cause hospitalization.& COPY; 2023 AMDA -The Society for Post-Acute and Long-Term Care Medicine.
引用
收藏
页码:937 / 944.e3
页数:11
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