Associated factors of frailty in patients with chronic heart failure: A systematic review and meta-analysis

Abstract

Abstract Background: Although some researchers have explored the influencing factors of frailty in chronic heart failure (CHF) patients, frailty is affected by many factors, and their conclusions are inconsistent. This review aims to systematically evaluate the factors affecting frailty in CHF patients to provide an evidence-based basis for risk prediction, treatment plans, and the prevention of health outcomes in clinical settings. Methods: EMBASE, the Cochrane Library, PubMed, Web of Science, CINAHL, Chinese Biological Medicine (CBM), CNKI, and Wan Fang databases were searched up to August 10, 2023, to identify observational studies to assemble the factors affecting frailty in CHF patients. Two independent reviewers assessed the quality of included studies using corresponding assessment tools. RevMan 5.4 was used for meta-analysis and sensitivity analysis. Stata 18 MP was used for publication bias assessment. Results: 14 articles including 4310 patients were included. 16 influencing factors were identified, and the factors with statistical significance were age (OR=1.11, 95% CI=1.07-1.16, p<0.001), NYHA functional class (OR=3.15, 95% CI=2.46-4.04, p<0.001), albumin (OR=0.86, 95% CI=0.77-0.95, p=0.005), haemoglobin (OR=0.86, 95% CI=0.76-0.97, p=0.01), cerebrovascular accidents (OR=2.31, 95% CI=1.49-3.06, P<0.001), number of comorbidities (OR=1.24, 95%CI=1.05-1.47, P=0.01), left ventricular ejection fraction (LVEF) (OR=0.88, 95% CI=0.78-0.99, p=0.03), duration of hospitalization (OR=1.14, 95% CI=1.05-1.23, p=0.001) and left atrial diameter (OR=1.12, 95% CI=1.05-1.20, P=0.0006). Conclusions: While this review and meta-analysis found that age, NYHA functional class, albumin, haemoglobin, cerebrovascular accidents, comorbidity, LVEF, duration of hospitalization, left atrial diameter were associated with frailty in patients with chronic heart failure, the study heterogeneity shows the need for better-designed studies to further clarify the influencing factors of frailty in CHF patients and develop disease prediction models based on an algorithm for predicting the risk of frailty more accurately.