Zou Yupei, Han Maonan, Wang Jiarong, Zhao Jichun, Gan Huatian, Yang Yi
The Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, China.
National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China.
Ann Transl Med. 2022 Feb;10(4):166. doi: 10.21037/atm-22-274.
The present study aimed to analyze the impact of frailty on mortality risk among hospitalized patients with coronavirus disease 2019 (COVID-19).
Literature searches were conducted using the MEDLINE, Embase, and Cochrane databases for articles reporting the association between frailty and mortality in hospitalized patients with COVID-19. The quality of the included studies was assessed using the Newcastle-Ottawa scale (NOS). A random-effects meta-analysis was performed to calculate the pooled effects.
A total of 21 studies with 26,652 hospitalized patients were included. Sixteen studies used the Clinical Frailty Score (CFS), and five used other frailty assessment tools. The pooled estimates of frailty in hospitalized patients with COVID-19 were 51.4% [95% confidence interval (CI): 39.9-62.9%]. In the CFS group, frail patients experienced a higher rate of short-term mortality than non-frail patients [odds ratio (OR) =3.0; 95% CI: 2.3-3.9; I=72.7%; P<0.001]. In the other tools group, frail patients had a significantly increased short-term mortality risk compared with non-frail patients (OR =2.4; 95% CI: 1.4-4.1; P=0.001). Overall, a higher short-term mortality risk was observed for frail patients than non-frail patients (OR =2.8; 95% CI: 2.3-3.5; P<0.001). In older adults, frail patients had a higher rate of short-term mortality than non-frail patients (OR =2.3; 95% CI: 1.8-2.9; P<0.001).
Compared to non-frail hospitalized patients with COVID-19, frail patients suffered a higher risk of all-cause mortality, and this result was also found in the older adult group.
本研究旨在分析衰弱对2019冠状病毒病（COVID-19）住院患者死亡风险的影响。
使用MEDLINE、Embase和Cochrane数据库进行文献检索，以查找报告COVID-19住院患者衰弱与死亡率之间关联的文章。使用纽卡斯尔-渥太华量表（NOS）评估纳入研究的质量。进行随机效应荟萃分析以计算合并效应。
共纳入21项研究，涉及26,652名住院患者。16项研究使用临床衰弱评分（CFS），5项使用其他衰弱评估工具。COVID-19住院患者衰弱的合并估计值为51.4%[95%置信区间（CI）：39.9 - 62.9%]。在CFS组中，衰弱患者的短期死亡率高于非衰弱患者[比值比（OR）= 3.0；95% CI：2.3 - 3.9；I² = 72.7%；P < 0.001]。在其他工具组中，与非衰弱患者相比，衰弱患者的短期死亡风险显著增加（OR = 2.4；95% CI：1.4 - 4.1；P = 0.001）。总体而言，衰弱患者的短期死亡风险高于非衰弱患者（OR = 2.8；95% CI：2.3 - 3.5；P < 0.001）。在老年人中，衰弱患者的短期死亡率高于非衰弱患者（OR = 2.3；95% CI：1.8 - 2.9；P < 0.001）。
与非衰弱的COVID-19住院患者相比，衰弱患者的全因死亡风险更高，且在老年人群体中也发现了这一结果。
