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. 2021 Oct 4:8:637446.
doi: 10.3389/fmed.2021.637446. eCollection 2021.

Association of Frailty With the Risk of Mortality and Resource Utilization in Elderly Patients in Intensive Care Units: A Meta-Analysis

Feiping Xia  1 , Jing Zhang  1 , Shanshan Meng  2 , Haibo Qiu  2 , Fengmei Guo  2
Affiliations

Association of Frailty With the Risk of Mortality and Resource Utilization in Elderly Patients in Intensive Care Units: A Meta-Analysis

Feiping Xia et al. Front Med (Lausanne). .

Abstract

Background: The associations of frailty with the risk of mortality and resource utilization in the elderly patients admitted to intensive care unit (ICU) remain unclear. To address these issues, we performed a meta-analysis to determine whether frailty is associated with adverse outcomes and increased resource utilization in elderly patients admitted to the ICU. Methods: We searched PubMed, EMBASE, ScienceDirect, and Cochrane Central Register of Controlled Trials through August 2021 to identify the relevant studies that investigated frailty in elderly (≥ 65 years old) patients admitted to an ICU and compared outcomes and resource utilization between frail and non-frail patients. The primary outcome was mortality. We also investigated the prevalence of frailty and the impact of frailty on the health resource utilization, such as hospital length of stay (LOS) and resource utilization of ICU. Results: A total of 13 observational studies enrolling 64,279 participants (28,951 frail and 35,328 non-frail) were finally included. Frailty was associated with an increased risk of short-term mortality (10 studies, relative risk [RR]: 1.70; 95% CI: 1.45-1.98), in-hospital mortality (five studies, RR: 1.73; 95% CI: 1.55-1.93), and long-term mortality (six studies, RR: 1.86; 95% CI: 1.44-2.42). Subgroup analysis showed that retrospective studies identified a stronger correlation between frailty and hospital LOS (three studies, MD 1.14 d; 95% CI: 0.92-1.36). Conclusions: Frailty is common in the elderly patients admitted to ICU, and is associated with increased mortality and prolonged hospital LOS. Trial registration: This study was registered in the PROSPERO database (CRD42020207242).

Keywords: elderly intensive care unit patients; frailty; hospital length of stay; meta-analysis; mortality.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Preferred reporting items for systematic reviews and meta-analyses flow diagram.
Figure 2
Figure 2
Prevalence of frailty in the elderly patients admitted to ICU according to all the measures of frailty.
Figure 3
Figure 3
The association of frailty and mortality in elderly patients admitted to ICU. RR = relative risk. (A) The association of frailty and short-term mortality in elderly patients admitted to ICU. (B) The association of frailty and in-hospital mortality in the elderly patients admitted to ICU. (C) The association of frailty and long-term mortality in the elderly patients admitted to ICU.
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