Institute of Molecular Biology & Translational Medicine, The Affiliated People's Hospital, Jiangsu University, Zhenjiang, Jiangsu 212002, China.
Department of General Surgery, The Affiliated People's Hospital, Jiangsu University, Zhenjiang, Jiangsu 212002, China.
Ageing Res Rev. 2022 Jan;73:101527. doi: 10.1016/j.arr.2021.101527. Epub 2021 Nov 26.
Conflicting results have been reported on the impact of frailty on adverse outcomes in patients with atrial fibrillation (AF). The aim of this meta-analysis was to evaluate the impact of frailty on death and major bleeding in patients with AF.
We comprehensively searched PubMed and Embase databases until June 30, 2021 for the relevant studies that investigated the impact of frailty on all-cause mortality and major bleeding in AF patients. Pooled multivariable-adjusted risk ratio (RR) and 95% confidence intervals (CI) was estimated for the frail vs. nonfrail patients using a random-effect model.
Ten studies involving 97,413 patients with AF satisfied the inclusion criteria. The prevalence of frailty in patients with AF ranged between 5.9% and 89.5%. Meta-analysis indicated that frailty was associated with higher risk of all-cause mortality (RR 2.77; 95% CI 1.68-4.57) and major bleeding (RR 1.83; 95% CI 1.24-2.71). Subgroup analysis showed that the impact of frailty on all-cause mortality was consistently found in each subgroup.
Frailty independently predicts all-cause mortality and major bleeding in patients with AF. Determination of frailty status may play an important role in risk classification of AF patients. However. lack of standardized definition of frailty is the most important limitations of this meta-analysis.
关于衰弱对房颤（AF）患者不良结局的影响，已有相互矛盾的结果报道。本荟萃分析的目的是评估衰弱对 AF 患者死亡和大出血的影响。
我们全面检索了 PubMed 和 Embase 数据库，截至 2021 年 6 月 30 日，以寻找评估衰弱对 AF 患者全因死亡率和大出血影响的相关研究。使用随机效应模型对衰弱与非衰弱患者进行多变量调整风险比（RR）和 95%置信区间（CI）的汇总。
纳入了 10 项涉及 97413 例 AF 患者的研究。AF 患者衰弱的患病率在 5.9%至 89.5%之间。荟萃分析表明，衰弱与全因死亡率（RR 2.77；95% CI 1.68-4.57）和大出血（RR 1.83；95% CI 1.24-2.71）风险增加相关。亚组分析表明，衰弱对全因死亡率的影响在每个亚组中均一致存在。
衰弱独立预测 AF 患者的全因死亡率和大出血。确定衰弱状态可能在 AF 患者的风险分类中发挥重要作用。然而，缺乏衰弱的标准化定义是本荟萃分析的最重要限制。
