Padhi Bijaya K, Gandhi Aravind P, Sandeep Mokanpally, Shamim Muhammad A, De Arka, Rathi Sahaj, Singh Surender, Duseja Ajay, Taneja Sunil
Department of Community Medicine and School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India.
Department of Community Medicine, All India Institute of Medical Sciences, Nagpur, India.
J Clin Exp Hepatol. 2024 Jul-Aug;14(4):101373. doi: 10.1016/j.jceh.2024.101373. Epub 2024 Feb 20.
BACKGROUND & AIMS: Frailty in patients with cirrhosis is associated with increased morbidity and mortality. In this study, we aimed to determine the prevalence of frailty and its impact on mortality and hospitalization in patients with cirrhosis.
An elaborate search was undertaken in the databases "PubMed, Scopus, Web of Science, and Cochrane, and preprint servers", and an assessment of all published articles till 17 February 2023 was done. Studies that provided data on prevalence, mortality and hospitalization among frail patients with cirrhosis were included. The study characteristics and data on the prevalence, mortality, and hospitalization were extracted from included studies. The primary outcome was to estimate the pooled prevalence of frailty and determine its impact on mortality and hospitalization in patients with cirrhosis.
Overall, 12 studies were included. Data on prevalence of frailty and mortality were available in 11 studies, while seven studies reported data on hospitalization. The analysis conducted among 6126 patients with cirrhosis revealed pooled prevalence of frailty to be 32% (95% confidence interval [CI], 24-41). A total of 540 events of death revealed a pooled mortality rate of 29% (95% CI, 19-41). Six-month and twelve-month pooled estimates of mortality were found to be 24% (95% CI, 17-33) and 33% (95% CI, 23-45), respectively. The pooled hospitalization rate among the seven studies was 43% (95% CI, 21-68).
The prevalence of frailty in patients with cirrhosis is high, leading to poor outcomes. Frailty assessment should become an integral part of cirrhosis evaluation.
PROSPERO 2022 CRD42022377507.
肝硬化患者的衰弱与发病率和死亡率增加相关。在本研究中，我们旨在确定肝硬化患者衰弱的患病率及其对死亡率和住院率的影响。
在“PubMed、Scopus、Web of Science和Cochrane数据库以及预印本服务器”中进行了详尽的检索，并对截至2023年2月17日发表的所有文章进行了评估。纳入了提供肝硬化衰弱患者患病率、死亡率和住院率数据的研究。从纳入的研究中提取研究特征以及患病率、死亡率和住院率的数据。主要结果是估计衰弱的合并患病率，并确定其对肝硬化患者死亡率和住院率的影响。
总体而言，纳入了12项研究。11项研究提供了衰弱患病率和死亡率数据，7项研究报告了住院率数据。对6126例肝硬化患者进行的分析显示，衰弱的合并患病率为32%（95%置信区间[CI]，24 - 41）。共有540例死亡事件，合并死亡率为29%（95%CI，19 - 41）。六个月和十二个月的合并死亡率估计分别为24%（95%CI，17 - 33）和33%（95%CI，23 - 45）。七项研究中的合并住院率为43%（95%CI，21 - 68）。
肝硬化患者衰弱的患病率很高，导致预后不良。衰弱评估应成为肝硬化评估的一个组成部分。
PROSPERO 2022 CRD42022377507
