Impact of Frailty on Mortality and Hospitalization in Chronic Heart Failure : A Systematic Review and Meta-Analysis
Yang, Xiaobo (The Chinese University of Hong Kong)
Lupón, Josep (Universitat Autònoma de Barcelona. Departament de Medicina)
Vidán, Maria T. (Universidad Complutense de Madrid)
Ferguson, Caleb (Western Sydney University)
Gastelurrutia, Paloma (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Newton, Phillip J. (Western Sydney University)
Macdonald, Peter S. (Heart and Lung Transplant Unit. St Vincent's Hospital University of New South Wales (Sydney, Austràlia))
Bueno, Héctor (Hospital Universitario 12 de Octubre (Madrid))
Bayés-Genís, Antoni (Universitat Autònoma de Barcelona. Departament de Medicina)
Woo, Jean (The Chinese University of Hong Kong)
Fung, Erik (The Chinese University of Hong Kong)

Fecha:	2018
Resumen:	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 () were pooled for meta-analyses, and where odds ratios were used previously, original data were recalculated for . 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 (, 1. 54; 95% confidence interval, 1. 34-1. 75; P <0. 001) and incident hospitalization (, 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 (, 1. 80; 95% confidence interval, 1. 41-2. 28; P <0. 001), but not for hospitalization (, 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.
Ayudas:	Ministerio de Economía y Competitividad SAF2014-59892 Ministerio de Economía y Competitividad RD16/0011/0006 Ministerio de Economía y Competitividad CB16/11/00403 Ministerio de Economía y Competitividad SEV-2015-0505 Fundació la Marató de TV3 201502-30 Fundació la Marató de TV3 201516-10
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	Chronic heart failure ; Frailty ; Hospitalization ; Meta-analysis ; Mortality
Publicado en:	Journal of the American Heart Association. Cardiovascular and cerebrovascular disease, Vol. 7, Num. 23 (december 2018) , ISSN 2047-9980

DOI: 10.1161/JAHA.117.008251
PMID: 30571603

19 p, 1.2 MB

El registro aparece en las colecciones:
Documentos de investigación > Documentos de los grupos de investigación de la UAB > Centros y grupos de investigación (producción científica) > Ciencias de la salud y biociencias > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP)
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