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Meta-Analysis
. 2023 Nov;18(8):2423-2434.
doi: 10.1007/s11739-023-03405-6. Epub 2023 Sep 5.

Frailty and its influence on mortality and morbidity in COPD: A Systematic Review and Meta-Analysis

Alessia Verduri  1   2 , Ben Carter  3 , James Laraman  4 , Ceara Rice  4 , Enrico Clini  5 , Nick Anthony Maskell  6 , Jonathan Hewitt  4
Affiliations
Meta-Analysis

Frailty and its influence on mortality and morbidity in COPD: A Systematic Review and Meta-Analysis

Alessia Verduri et al. Intern Emerg Med. 2023 Nov.

Abstract

Frailty increases vulnerability to adverse outcomes. Long-term conditions increase the risk of frailty. We searched PubMed, Web of Science, The Cochrane Library, EMBASE from inception to March 2022. Quality assessment was conducted using the NOS. Data was analysed in a pooled a random-effects meta-analysis. Our primary outcome was the impact of frailty on mortality in adults with Chronic Obstructive Pulmonary Disease (COPD) diagnosis according to the guidelines. Secondary outcomes were: frailty and association with readmissions, hospitalisations, exacerbation rates, and prevalence of frailty in COPD. We identified 25 studies, with 5882 participants. The median prevalence of frailty was 47% (IQR, 39.3-66.3%, range 6.4-72%). There was an association between COPD patients living with frailty and increased risk of mortality versus COPD patients without frailty (pooled OR, 4.21 (95% CI 2.99-5.93, I2 55%). A descriptive analysis of relationship between frailty and hospital readmission and all cause hospitalization showed positive associations. The relationship between frailty and the risk of exacerbation showed a pooled OR, 1.45 (95% CI 0.37-5.70, I2 80%). Frailty is significantly associated with higher mortality risk in COPD. Frailty is common in patients with COPD and its measurement should be considered in clinical practice to better characterise COPD.

Keywords: COPD; Exacerbation; Frailty; Hospitalization; Mortality; Readmission.

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Conflict of interest statement

We all declare no competing interests.

Figures

Fig. 1
Fig. 1
PRISMA Flowchart of the included studies on COPD. From: Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al (2021) The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 372:n71
Fig. 2
Fig. 2
A meta-analysis of frailty and mortality in COPD. Forest plot demonstrating effect of frailty on all-cause short- and long-term mortality. The mortality of patients with COPD living with or without frailty were compared across nine studies
See this image and copyright information in PMC

References

    1. Adeloye D, Song P, Zhu Y, et al. Global, regional, and national prevalence of, and risk factors for, chronic obstructive pulmonary disease (COPD) in 2019: a systematic review and modelling analysis. Lancet Respir Med. 2022;10(5):447–458. - PMC - PubMed
    1. Verduri A, Hewitt J, Carter B, et al (2022) Prevalence of asthma and COPD in a cohort of patients at the follow up after COVID-19 pneumonia. Pulmonology 10:S2531–0437(22)00127–1 - PMC - PubMed
    1. Clegg A, Young J, Iliffe S, et al. Frailty in elderly people. Lancet. 2013;381(9868):752–762. - PMC - PubMed
    1. Fried LP, Tangen CM, Walston J, et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci. 2001;56(3):M146–M156. - PubMed
    1. Mitnitski AB, Mogilner AJ, Rockwood K. Accumulation of deficits as a proxy measure of aging. Sci World J. 2001;1:323–336. - PMC - PubMed