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Meta-Analysis
. 2023 May 12;23(1):164.
doi: 10.1186/s12890-023-02454-z.

Prevalence and clinical impact of frailty in COPD: a systematic review and meta-analysis

Lina Wang #  1 , Xiaolin Zhang #  1 , Xinmin Liu  2
Affiliations
Meta-Analysis

Prevalence and clinical impact of frailty in COPD: a systematic review and meta-analysis

Lina Wang et al. BMC Pulm Med. .

Abstract

Background: Frailty has been increasingly identified as a risk factor of adverse outcomes in chronic obstructive pulmonary disease (COPD). The prevalence and impact of frailty on health outcomes in people with COPD require clarification.

Methods: PubMed, Embase, The Cochrane Library and Web of Science (January 1, 2002, to July 1, 2022) were comprehensively searched to identify studies related to frailty and COPD. Comparisons were made between people who did and did not have frailty for pulmonary function, dyspnea severity, 6-minute walking distance, activities of daily life, and mortality.

Results: Twenty studies (9 cross-sectional, 10 cohort studies,1 clinical trial) from Europe (9), Asia (6), and North and South America (4), Oceania (1) involving 11, 620 participants were included. The prevalence of frailty was 32.07% (95% confidence interval (CI) 26.64-37.49) with a range of 6.43-71.70% based on the frailty tool used. People with frailty had lower predicted forced expiratory volume in the first second (mean difference - 5.06%; 95%CI -6.70 to -3.42%), shorter 6-minute walking distance (mean difference - 90.23 m; 95%CI -124.70 to -55.76), poorer activities of daily life (standardized mean difference - 0.99; 95%CI -1.35 to -0.62), higher CAT(COPD Assessment Test) score(mean difference 6.2; 95%CI 4.43 to 7.96) and mMRC (modified Medical Research Council) grade (mean difference 0.93; 95%CI 0.85 to 1.02) compared with those who did not (P < 0.001 for all). Meta-analysis showed that frailty was associated with an increased risk of long-term all-cause mortality (HR 1.68; 95% CI 1.37-2.05; I2 = 0%, P < 0.001).

Conclusion: Frailty is prevalent in people with COPD and linked with negative clinical outcomes including pulmonary function, dyspnea severity, exercise capacity, quality of life and mortality.

Keywords: Chronic obstructive pulmonary disease; Frailty; Mortality; Prevalence; meta-analysis.

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Conflict of interest statement

The authors declare that there are no competing interests.

Figures

Fig. 1
Fig. 1
Flow diagram of the study selection process
Fig. 2
Fig. 2
Prevalence of frailty in chronic obstructive pulmonary disease. CI, confidence interval; ES, effect size (prevalence%)
Fig. 3
Fig. 3
Impact of frailty on pulmonary function and dyspnea severity in individuals with COPD. COPD, chronic obstructive pulmonary disease; CAT, COPD Assessment Test; mMRC, modified Medical Research Council
Fig. 4
Fig. 4
Impact of frailty on 6MWD and ADL in individuals with COPD. COPD, chronic obstructive pulmonary disease;6MWD, six minutes walking distance; ADL, activities of daily living
Fig. 5
Fig. 5
Impact of frailty on mortality in individuals with COPD. COPD, chronic obstructive pulmonary disease
See this image and copyright information in PMC

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