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Meta-Analysis
. 2017 Jun 1:236:283-289.
doi: 10.1016/j.ijcard.2017.01.153. Epub 2017 Feb 10.

The prevalence of frailty in heart failure: A systematic review and meta-analysis

Quin E Denfeld  1 , Kerri Winters-Stone  2 , James O Mudd  3 , Jill M Gelow  3 , Sawsan Kurdi  4 , Christopher S Lee  5
Affiliations
Meta-Analysis

The prevalence of frailty in heart failure: A systematic review and meta-analysis

Quin E Denfeld et al. Int J Cardiol. .

Abstract

Background: There is a growing interest in the intersection of heart failure (HF) and frailty; however, estimates of the prevalence of frailty in HF vary widely. The purpose of this paper was to quantitatively synthesize published literature on the prevalence of frailty in HF and to examine the relationship between study characteristics (i.e. age and functional class) and the prevalence of frailty in HF.

Methods: The prevalence of frailty in HF, divided into Physical Frailty and Multidimensional Frailty measures, was synthesized across published studies using a random-effects meta-analysis of proportions approach. Meta-regression was performed to examine the influence of age and functional class (at the level of the study) on the prevalence of frailty.

Results: A total of 26 studies involving 6896 patients with HF were included in this meta-analysis. Despite considerable differences across studies, the overall estimated prevalence of frailty in HF was 44.5% (95% confidence interval, 36.2%-52.8%; z=10.54; p<0.001). The prevalence was slightly lower among studies using Physical Frailty measures (42.9%, z=9.05; p<0.001) and slightly higher among studies using Multidimensional Frailty measures (47.4%, z=5.66; p<0.001). There were no significant relationships between study age or functional class and prevalence of frailty.

Conclusions: Frailty affects almost half of patients with HF and is not necessarily a function of age or functional classification. Future work should focus on standardizing the measurement of frailty and on broadening the view of frailty beyond a strictly geriatric syndrome in HF.

Keywords: Aging; Frailty; Heart failure; Meta-analysis.

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Conflict of interest statement

Conflicts of Interest

None

Figures

Figure 1
Figure 1. PRISMA Flow Diagram
PRISMA flow diagram showing study identification, selection, eligibility, and inclusion. From: Moher D, Liberati A, Tetzlaff J, Altman DG, The PRISMA Group (2009). Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement. PLoS Med 6(6): e1000097. doi:10.1371/journal.pmed1000097 For more information, visit www.prisma-statement.org.
Figure 2
Figure 2. Estimated Prevalence of Frailty in Heart Failure
Random effects meta-analysis of prevalence of frailty in heart failure by measurement type (Physical Frailty (z = 9.05, p < 0.001; denoted by short-dashed line) and Multidimensional Frailty (z = 5.66 p < 0.001; denoted by long-dashed line) and overall (z = 10.54, p < 0.001; denoted by solid line)). CI = confidence interval; Wt = weight.
See this image and copyright information in PMC

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