Denfeld Quin E, Winters-Stone Kerri, Mudd James O, Gelow Jill M, Kurdi Sawsan, Lee Christopher S
Oregon Health & Science University Knight Cardiovascular Institute, Portland, OR, USA; Oregon Health & Science University School of Nursing, Portland, OR, USA.
Oregon Health & Science University School of Nursing, Portland, OR, USA; Oregon Health & Science University Knight Cancer Institute, Portland, OR, USA.
Int J Cardiol. 2017 Jun 1;236:283-289. doi: 10.1016/j.ijcard.2017.01.153. Epub 2017 Feb 10.
There is a growing interest in the intersection of heart failure (HF) and frailty; however, estimates of the prevalence of frailty in HF vary widely. The purpose of this paper was to quantitatively synthesize published literature on the prevalence of frailty in HF and to examine the relationship between study characteristics (i.e. age and functional class) and the prevalence of frailty in HF.
The prevalence of frailty in HF, divided into Physical Frailty and Multidimensional Frailty measures, was synthesized across published studies using a random-effects meta-analysis of proportions approach. Meta-regression was performed to examine the influence of age and functional class (at the level of the study) on the prevalence of frailty.
A total of 26 studies involving 6896 patients with HF were included in this meta-analysis. Despite considerable differences across studies, the overall estimated prevalence of frailty in HF was 44.5% (95% confidence interval, 36.2%-52.8%; z=10.54; p<0.001). The prevalence was slightly lower among studies using Physical Frailty measures (42.9%, z=9.05; p<0.001) and slightly higher among studies using Multidimensional Frailty measures (47.4%, z=5.66; p<0.001). There were no significant relationships between study age or functional class and prevalence of frailty.
Frailty affects almost half of patients with HF and is not necessarily a function of age or functional classification. Future work should focus on standardizing the measurement of frailty and on broadening the view of frailty beyond a strictly geriatric syndrome in HF.
心力衰竭（HF）与衰弱之间的交叉领域正受到越来越多的关注；然而，HF中衰弱患病率的估计差异很大。本文的目的是对已发表的关于HF中衰弱患病率的文献进行定量综合分析，并研究研究特征（即年龄和功能分级）与HF中衰弱患病率之间的关系。
使用随机效应比例荟萃分析方法，对已发表研究中HF的衰弱患病率进行综合分析，分为身体衰弱和多维衰弱测量。进行荟萃回归分析，以研究年龄和功能分级（在研究层面）对衰弱患病率的影响。
本荟萃分析共纳入26项研究，涉及6896例HF患者。尽管各研究之间存在相当大的差异，但HF中衰弱的总体估计患病率为44.5%（95%置信区间，36.2%-52.8%；z=10.54；p<0.001）。使用身体衰弱测量的研究中患病率略低（42.9%，z=9.05；p<0.001），使用多维衰弱测量的研究中患病率略高（47.4%，z=5.66；p<0.001）。研究年龄或功能分级与衰弱患病率之间无显著关系。
衰弱影响几乎一半的HF患者，不一定是年龄或功能分级的函数。未来的工作应侧重于使衰弱测量标准化，并将衰弱的观点从HF中严格的老年综合征扩展。
