Frailty as a predictor of adverse outcomes in hospitalized older adults: A systematic review and meta-analysis |
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| Institution: | 1. Master’s and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo – UNICID, São Paulo, Brazil;2. National Research Council, Neurosciences Department, Aging Branch, Padova, Italy;3. Faculty of Physical Therapy and Pharmacy, Universidade Santa Cecília – UNISANTA, Santos, Brazil;1. School of Nursing, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, Shandong 271016, China;2. School of Public Health, Shandong First Medical University &Shandong Academy of Medical Sciences, Taian, Shandong Province, 271016, China;3. Shangdong Medical College, Linyi, Shandong Province, 276000, China;4. Taishan Sanatorium, Taian, Shandong Province, 271000, China;5. Tongren Eye Hospital, Taian, Shandong Province, 271000, China;1. Thematic Area for Frailty and Healthy Ageing of the Network of Biomedical Research Centers (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain;2. Geriatric Department, Hospital Virgen del Valle, Complejo Hospitalario de Toledo, Toledo, Spain;3. Biomedical Research Foundation, Hospital Universitario de Getafe, Madrid, Spain;4. Geriatric Department, Hospital Universitario de Getafe, Madrid, Spain;1. Gerontology Department, Vrije Universiteit Brussel (VUB), Brussels, Belgium;2. Frailty in Ageing (FRIA) Research Department, Vrije Universiteit Brussel (VUB), Brussels, Belgium;3. Geriatrics Department, Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium;4. Rehabilitation Sciences Research Department (RERE), Vrije Universiteit Brussel, Brussels, Belgium;5. Fundamental Rights and Constitutionalism Research Group (FRC), Vrije Universiteit Brussel (VUB), Elsene, Belgium;6. Experimental Anatomy (EXAN), Vrije Universiteit Brussel (VUB), Brussels, Belgium;7. Department of Electronics and Informatics ETRO, Vrije Universiteit Brussel (VUB), Elsene, Belgium;1. Department of Emergency, The Affiliated Baoan Hospital of Southern Medical University, The People''s Hospital of Baoan ShenZhen, Shenzhen, China;2. Department of Nursing, The First Affiliated hospital of ShenZhen University, The Second People''s Hospital of ShenZhen, Shenzhen, China;3. Department of Nursing, The Affiliated Baoan Hospital of Southern Medical University, The People''s Hospital of Baoan ShenZhen, Shenzhen, China;4. The Third Affiliated Hospital of Guangzhou Medical University, Research Institute of Gynecology & Obstetrics, Guangzhou, China |
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| Abstract: | Frailty syndrome is prevalent among hospitalized older adults as are the occurrence of adverse outcomes. This systematic review and meta-analysis investigated whether frailty in older adults at hospital admission predicts adverse outcomes. Manual (ProQuest, conferences annals and references) and electronic searches (PUBMED, EMBASE, Web of Science, Lilacs, CINAHL, PsycINFO and Google Scholar) were performed. We included prospective studies of hospitalized older adults. Primary outcomes were functional decline at hospital discharge and mortality after discharge. Other data were considered secondary outcomes. Methodological quality was evaluated by the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. Twenty-eight papers were included, corresponding to 19 cohorts (5 cohorts for functional decline and 16 for mortality), with moderate to good methodological quality. Being frail RR: 1.32 (95%CI: 1.04; 1.67)] and pre-frail RR: 1.51 (95%CI: 1.05; 2.17)] are risk factors for functional decline compared with being nonfrail. Frail individuals had a relative risk for in-hospital mortality and mortality in medium- and long-term compared to nonfrail (in-hospital RR: 8.20, medium RR: 9.49 and long RR: 7.94) and pre-frail (in-hospital RR: 3.19, medium RR: 3.31 and long RR: 3.72). The overall mortality risk in frail individuals is 3.49 and 2.14 times compared to nonfrail and pre-frail, respectively. Length of hospital stay was higher for frail older adults (13.5 days) compared with pre-frail (10.5 days) and nonfrail (8.3 days). Therefore, being frail at hospital admission is a risk factor for in-hospital mortality, long hospital stay, functional decline at hospital discharge, and mortality in the medium- and long-term. |
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| Keywords: | Frailty Older adults Adverse effects Mortality Hospital |
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