Impact of frailty on mortality and hospitalization in chronic heart failure: A systematic review and meta-analysis

Yang, X; Lupón, J; Vidán, MT; Ferguson, C; Gastelurrutia, P; Newton, PJ; Macdonald, PS; Bueno, H; Bayés-Genís, A; Woo, J; Fung, E

Impact of frailty on mortality and hospitalization in chronic heart failure: A systematic review and meta-analysis

Yang, X Lupón, J Vidán, MT Ferguson, C

Gastelurrutia, P Newton, PJ

Macdonald, PS

Bueno, H Bayés-Genís, A Woo, J Fung, E

Permalink

Publication Type:: Journal Article
Citation:: Journal of the American Heart Association, 2018, 7 (23)
Issue Date:: 2018-12-01

Open Access

Copyright Clearance Process

Recently Added
In Progress
Open Access

This item is open access.

Adobe PDF

Download Published VersionAdobe PDF (1.15 MB)

View on publisher's site

View statistics

Full metadata record

Field	Value	Language
dc.contributor.author	Yang, X	en_US
dc.contributor.author	Lupón, J	en_US
dc.contributor.author	Vidán, MT	en_US
dc.contributor.author	Ferguson, C https://orcid.org/0000-0002-2417-2216	en_US
dc.contributor.author	Gastelurrutia, P	en_US
dc.contributor.author	Newton, PJ https://orcid.org/0000-0002-5006-2037	en_US
dc.contributor.author	Macdonald, PS https://orcid.org/0000-0001-5378-2825	en_US
dc.contributor.author	Bueno, H	en_US
dc.contributor.author	Bayés-Genís, A	en_US
dc.contributor.author	Woo, J	en_US
dc.contributor.author	Fung, E	en_US
dc.date.issued	2018-12-01	en_US
dc.identifier.citation	Journal of the American Heart Association, 2018, 7 (23)	en_US
dc.identifier.uri	http://hdl.handle.net/10453/129345
dc.description.abstract	© 2018 The Authors. 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 ≈1.5-fold.	en_US
dc.relation.ispartof	Journal of the American Heart Association	en_US
dc.relation.isbasedon	10.1161/JAHA.117.008251	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Chronic Disease	en_US
dc.subject.mesh	Hospitalization	en_US
dc.subject.mesh	Risk Factors	en_US
dc.subject.mesh	Heart Failure	en_US
dc.subject.mesh	Frailty	en_US
dc.title	Impact of frailty on mortality and hospitalization in chronic heart failure: A systematic review and meta-analysis	en_US
dc.type	Journal Article
utslib.citation.volume	23	en_US
utslib.citation.volume	7	en_US
utslib.for	1102 Cardiorespiratory Medicine and Haematology	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/IMPACCT
pubs.organisational-group	/University of Technology Sydney/Strength - CHSP - Health Services and Practice
utslib.copyright.status	open_access
pubs.issue	23	en_US
pubs.publication-status	Published	en_US
pubs.volume	7	en_US

Abstract:

© 2018 The Authors. 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 ≈1.5-fold.

Please use this identifier to cite or link to this item:

http://hdl.handle.net/10453/129345