Impact of frailty on all-cause mortality and major bleeding in patients with atrial fibrillation: A meta-analysis |
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Institution: | 1. Division of Cardiology, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York;2. Division of Cardiology, Department of Medicine, Houston Methodist Hospital, Houston, Texas;3. Department of Health Sciences Research, Division of Biomedical Statistics and Informatics Mayo Clinic, Rochester, Minnesota;4. Division of Geriatrics, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York;1. School of Public Health, Tianjin Medical University, Tianjin, China;2. School of Public Health, Hangzhou Normal University, Hongzhou, China;3. School of nurse, Tianjin Medical University, Tianjin, China;4. School of Public Health, Zhejiang University School of Medicine, Hangzhou, China |
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Abstract: | BackgroundConflicting results have been reported on the impact of frailty on adverse outcomes in patients with atrial fibrillation (AF). The aim of this meta-analysis was to evaluate the impact of frailty on death and major bleeding in patients with AF.MethodsWe comprehensively searched PubMed and Embase databases until June 30, 2021 for the relevant studies that investigated the impact of frailty on all-cause mortality and major bleeding in AF patients. Pooled multivariable-adjusted risk ratio (RR) and 95% confidence intervals (CI) was estimated for the frail vs. nonfrail patients using a random-effect model.ResultsTen studies involving 97,413 patients with AF satisfied the inclusion criteria. The prevalence of frailty in patients with AF ranged between 5.9% and 89.5%. Meta-analysis indicated that frailty was associated with higher risk of all-cause mortality (RR 2.77; 95% CI 1.68–4.57) and major bleeding (RR 1.83; 95% CI 1.24–2.71). Subgroup analysis showed that the impact of frailty on all-cause mortality was consistently found in each subgroup.ConclusionFrailty independently predicts all-cause mortality and major bleeding in patients with AF. Determination of frailty status may play an important role in risk classification of AF patients. However. lack of standardized definition of frailty is the most important limitations of this meta-analysis. |
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Keywords: | Frailty Atrial fibrillation All-cause mortality Major bleeding Meta-analysis |
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