Frailty and its influence on mortality and morbidity in COPD: A systematic review and meta-analysis

Verduri, Alessia, Carter, Ben, Laraman, James, Rice, Ceara, Clini, Enrico, Maskell, Nick Anthony and Hewitt, Jonathan ORCID: https://orcid.org/0000-0002-7924-1792 2023. Frailty and its influence on mortality and morbidity in COPD: A systematic review and meta-analysis. Internal and Emergency Medicine 18 , pp. 2423-2434. 10.1007/s11739-023-03405-6

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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.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Medicine
Publisher:	Springer
ISSN:	1828-0447
Date of First Compliant Deposit:	2 October 2023
Date of Acceptance:	18 August 2023
Last Modified:	05 Jan 2024 06:48
URI:	https://orca.cardiff.ac.uk/id/eprint/162874

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