Department of Primary Care and Population Health, University College London, London, United Kingdom.
J Am Med Dir Assoc. 2018 Jun;19(6):480-483. doi: 10.1016/j.jamda.2018.04.006.
To conduct a systematic review of the literature on prospective cohort studies examining mortality risk according to frailty defined by FRAIL scale, and to perform a meta-analysis to synthesize the pooled risk estimates.
Systematic review and meta-analysis.
Embase, Scopus, MEDLINE, CINAHL, and PsycINFO were systematically searched in March 2018. References of included studies were reviewed and a forward citation tracking was performed on relevant review papers for additional studies. Additional data necessary for a meta-analysis were requested from corresponding authors.
Community-dwelling middle-aged and older adults.
Mortality risk due to frailty as defined by the FRAIL scale.
After removing duplicates, there are 81 citations for title, abstract, and full-text screening. Eight studies were included in this review. Four studies calculated the area under the receiver operating characteristic curve, which ranged from 0.54 to 0.70. A random-effects meta-analysis was conducted on 3 studies that provided adjusted hazard ratios (HRs) of mortality risk according to 3 frailty groups (robust, prefrail, and frail) defined by FRAIL scale. Both frailty and prefrailty were significantly associated with higher mortality risk than robustness [pooled HR = 3.53, 95% confidence interval (CI) = 1.66-7.49, P = .001; pooled HR = 1.75, 95% CI = 1.14-2.70, P = .01, respectively]. No evidence of publication bias was observed.
This study demonstrated that FRAIL scale is a tool that can effectively identify frailty/prefrailty status, as well as quantify frailty status in a graded manner in relation to mortality risk. Although its feasibility is of note, not many studies are yet using this relatively new tool. More studies are warranted regarding mortality and other health outcomes.
系统综述前瞻性队列研究，评估根据 FRAIL 量表定义的虚弱程度与死亡率风险的相关性，并进行荟萃分析以综合汇总风险估计值。
系统综述和荟萃分析。
2018 年 3 月，我们系统性检索了 Embase、Scopus、MEDLINE、CINAHL 和 PsycINFO 数据库。对纳入研究的参考文献进行综述，并对相关综述论文进行前瞻性引文追踪以获取更多研究。我们向相应的作者请求进行荟萃分析所需的其他数据。
居住在社区的中年和老年人。
根据 FRAIL 量表定义的虚弱导致的死亡率风险。
剔除重复项后，标题、摘要和全文筛选有 81 篇文献。本综述纳入了 8 项研究。其中 4 项研究计算了受试者工作特征曲线下面积，范围为 0.54 至 0.70。对提供了根据 FRAIL 量表定义的 3 个虚弱组（强壮、虚弱前期和虚弱）的调整后死亡率风险的危险比（HR）的 3 项研究进行了随机效应荟萃分析。虚弱和虚弱前期均与死亡率风险升高显著相关，优于强壮状态[汇总 HR=3.53，95%置信区间（CI）=1.66-7.49，P=0.001；汇总 HR=1.75，95%CI=1.14-2.70，P=0.01]。未观察到发表偏倚的证据。
这项研究表明，FRAIL 量表是一种有效的工具，可以有效识别虚弱/虚弱前期状态，并以分级的方式量化与死亡率风险相关的虚弱状态。尽管其可行性值得注意，但尚未有很多研究使用这种相对较新的工具。需要更多研究来评估其与死亡率和其他健康结果的相关性。
