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

Alessia Verduri; Ben Carter; James Laraman; Ceara Rice; Enrico Clini; Nick Anthony Maskell; Jonathan Hewitt

doi:10.1007/s11739-023-03405-6

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

Alessia Verduri^*
, Ben Carter
, James Laraman
, Ceara Rice
, Enrico Clini
, Nick Anthony Maskell
, Jonathan Hewitt

^*Corresponding author for this work

Biostatistics & Health Informatics

Cardiff Law School
University of Modena and Reggio Emilia
King's College London
Bristol Medical School

Research output: Contribution to journal › Review article › peer-review

35 Citations (Scopus)

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, I ² 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, I ² 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.

Original language	English
Pages (from-to)	2423-2434
Number of pages	12
Journal	Internal and emergency medicine
Volume	18
Issue number	8
Early online date	5 Sept 2023
DOIs	https://doi.org/10.1007/s11739-023-03405-6
Publication status	Published - Nov 2023

Keywords

COPD
Exacerbation
Frailty
Hospitalization
Mortality
Readmission

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10.1007/s11739-023-03405-6Licence: CC BY

Cite this

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

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, I 2 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, I 2 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",

author = "Alessia Verduri and Ben Carter and James Laraman and Ceara Rice and Enrico Clini and Maskell, \{Nick Anthony\} and Jonathan Hewitt",

note = "Funding Information: There was no direct funding was received for this study. This paper represents independent research part funded by the National Institute for Health Research (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King{\textquoteright}s College London. The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care (BC). Funding Information: AV was supported by a research fellowship at Cardiff University (UK) funded by CHIESI Italy. The sponsor had no role in study design, analysis, interpretation, or writing of the manuscript. This work has been presented in the form of abstract at the European Geriatric Medicine Society International Congress 2022 in London (UK). Publisher Copyright: {\textcopyright} 2023, The Author(s).",

year = "2023",

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doi = "10.1007/s11739-023-03405-6",

language = "English",

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pages = "2423--2434",

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TY - JOUR

T1 - Frailty and its influence on mortality and morbidity in COPD

T2 - A Systematic Review and Meta-Analysis

AU - Verduri, Alessia

AU - Carter, Ben

AU - Laraman, James

AU - Rice, Ceara

AU - Clini, Enrico

AU - Maskell, Nick Anthony

AU - Hewitt, Jonathan

N1 - Funding Information: There was no direct funding was received for this study. This paper represents independent research part funded by the National Institute for Health Research (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King’s College London. The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care (BC). Funding Information: AV was supported by a research fellowship at Cardiff University (UK) funded by CHIESI Italy. The sponsor had no role in study design, analysis, interpretation, or writing of the manuscript. This work has been presented in the form of abstract at the European Geriatric Medicine Society International Congress 2022 in London (UK). Publisher Copyright: © 2023, The Author(s).

PY - 2023/11

Y1 - 2023/11

N2 - 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, I 2 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, I 2 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.

AB - 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, I 2 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, I 2 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.

KW - COPD

KW - Exacerbation

KW - Frailty

KW - Hospitalization

KW - Mortality

KW - Readmission

UR - https://www.scopus.com/pages/publications/85169823722

U2 - 10.1007/s11739-023-03405-6

DO - 10.1007/s11739-023-03405-6

M3 - Review article

AN - SCOPUS:85169823722

SN - 1828-0447

VL - 18

SP - 2423

EP - 2434

JO - Internal and emergency medicine

JF - Internal and emergency medicine

IS - 8

ER -

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

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Keywords

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