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The prevalence of frailty in heart failure: A systematic review and meta-analysis

Published:February 10, 2017DOI:https://doi.org/10.1016/j.ijcard.2017.01.153

      Highlights

      • Almost half of all heart failure patients are considered frail.
      • Prevalence of frailty in heart failure was not related to age or functional class.
      • There is significant heterogeneity in the measurement of frailty in heart failure.
      • Future work should focus on standardizing a measure of frailty in heart failure.
      • There is a need to broaden our view of frailty beyond a strictly geriatric syndrome in heart failure.

      Abstract

      Background

      There is a growing interest in the intersection of heart failure (HF) and frailty; however, estimates of the prevalence of frailty in HF vary widely. The purpose of this paper was to quantitatively synthesize published literature on the prevalence of frailty in HF and to examine the relationship between study characteristics (i.e. age and functional class) and the prevalence of frailty in HF.

      Methods

      The prevalence of frailty in HF, divided into Physical Frailty and Multidimensional Frailty measures, was synthesized across published studies using a random-effects meta-analysis of proportions approach. Meta-regression was performed to examine the influence of age and functional class (at the level of the study) on the prevalence of frailty.

      Results

      A total of 26 studies involving 6896 patients with HF were included in this meta-analysis. Despite considerable differences across studies, the overall estimated prevalence of frailty in HF was 44.5% (95% confidence interval, 36.2%–52.8%; z = 10.54; p < 0.001). The prevalence was slightly lower among studies using Physical Frailty measures (42.9%, z = 9.05; p < 0.001) and slightly higher among studies using Multidimensional Frailty measures (47.4%, z = 5.66; p < 0.001). There were no significant relationships between study age or functional class and prevalence of frailty.

      Conclusions

      Frailty affects almost half of patients with HF and is not necessarily a function of age or functional classification. Future work should focus on standardizing the measurement of frailty and on broadening the view of frailty beyond a strictly geriatric syndrome in HF.

      Keywords

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