School of Nursing, Jilin University, 965 Xinjiang Street, Changchun, Jilin 130020, China.
Biomed Res Int. 2018 Oct 22;2018:8739058. doi: 10.1155/2018/8739058. eCollection 2018.
Numerous studies have investigated the prognostic role of frailty in elderly patients with heart failure (HF), but the limited size of the reported studies has resulted in continued uncertainty regarding its prognostic impact. The aim of this study was to integrate the findings of all available studies and estimate the impact of frailty on the prognosis of HF by performing a systematic review and meta-analysis.
PubMed, Embase, Cochrane, and Web of Science databases were searched from inception to November 8 2017 to identify eligible prospective studies. The Newcastle-Ottawa Scale (NOS) was used to evaluate study quality. The association between frailty and HF outcomes was reviewed. Overall hazard ratios (HRs) for the effects of frailty on all-cause mortality were pooled using a fixed-effect model and publication bias was evaluated using funnel plots.
A total of 10 studies involving 3033 elderly patients with HF were included in the systematic review and meta-analysis. All eligible studies indicated that frailty was of prognostic significance for HF patients. The HRs for the effects of frailty on all-cause mortality were 1.70 (95% confidence interval (CI): 1.41-2.04), based on the pooling of six studies that provided related data. However, publication bias was observed among the studies.
Frailty has a high prevalence among older patients with HF. Elderly HF patients with frailty have a poorer prognosis than those without frailty. Further studies are now required to implement the use of frailty assessment tools and explore effective interventions for frailty in older HF patients.
大量研究已经探讨了衰弱在老年心力衰竭（HF）患者中的预后作用，但由于报道的研究规模有限，其预后影响仍存在不确定性。本研究旨在整合所有可用研究的结果，并通过系统评价和荟萃分析来评估衰弱对 HF 预后的影响。
从建库到 2017 年 11 月 8 日，检索 PubMed、Embase、Cochrane 和 Web of Science 数据库，以确定合格的前瞻性研究。使用纽卡斯尔-渥太华量表（NOS）评估研究质量。审查衰弱与 HF 结局之间的关系。使用固定效应模型汇总衰弱对全因死亡率影响的总危险比（HR），并使用漏斗图评估发表偏倚。
系统评价和荟萃分析共纳入 10 项涉及 3033 例老年 HF 患者的研究。所有合格研究均表明衰弱对 HF 患者具有预后意义。基于提供相关数据的 6 项研究的汇总，衰弱对全因死亡率的 HR 为 1.70（95%置信区间（CI）：1.41-2.04）。然而，研究中存在发表偏倚。
衰弱在老年 HF 患者中较为普遍。衰弱的老年 HF 患者预后较无衰弱者差。现在需要进一步研究来实施衰弱评估工具的使用，并探索针对老年 HF 患者衰弱的有效干预措施。
