Review Article

Prognostic Value of Frailty for Older Patients with Heart Failure: A Systematic Review and Meta-Analysis of Prospective Studies

Table 1

Characteristics of the included studies.

First Author
Year
Country
N
Age (M±SD)
Female %
HF Type
HFr/pEF %
Mean EF %
NYHA Class III-IV %Follow Up DurationFrailty
Measure
Frailty
Prevalence
Frailty Definition

Boxer
2010
USA
59
77.0
28.81
chronic HF
HFrEF(100%)
NR
42.44 yearsFP25.40%a poor ability to cope with physiologic stress

Cacciatore
2005
Italy
120
75.9± 6.7
60.00
chronic HF
NR
NR
NR12 yearsFSS54.2%
(FSS 2-3)
includes not only hospitalization, health service utilization, caregiver stress, but also age–associated sensory deficits, functional impairment or degree of disability, cognitive and behavioural deficits, and lack of social support

Martín-Sánchez 2017
Spanin
465
82.4 ±7.2
61.00
Acute HF
NR
NR
23.130daysModified FP(self reported)36.30%a dynamic and nonlinear process that describes a state of vulnerability (reduced system reserves and capacity of response to stress situations) to stressors in older populations

Pulignano
2006
Italy
190
77.0±5.0
46.30
chronic HF
NR
32.94±10
NR1yearFSS40%
FSS(2-4)
a clinical state of increased vulnerability to adverse outcomes such as disability and mortality

Rodríguez-Pascual 2017
Spanin
497
85.2±7.3
61.00
chronic HF
HFpEF (79.3%)
NR
27.91yearFP57.50%an age-associated medical syndrome characterised by increased vulnerability to even minor stressors, which manifests as higher risk of adverse health outcomes including disability, hospitalisation and death

Vidán
2016
Spanin
416
80.0±6.1
49.50
chronic HF
HFpEF (51.0%)
NR
25.51 yearFP76%a geriatric syndrome of increased vulnerability to stressors due to cumulative declines across different physiological systems

Chaudhry
2013
USA
758
79.7±6.2
50.50
Newly diagnosed HF
HFpEF (56.8%)
NR
30.320 yearsGrip strength Gait speed41.8%
(for both grip strength and gait speed)
NR

Chiarantini
2010
Italy
157
80.0±0.5
49.70
Decompensated HF
HFpEF (46.0%)
43.4±14.7
59.9median follow-up of 444 daysSPPB50.9%
(SPPB 0-4)
NR

Madan
2016
USA
40
74.9± 6.5
57.50
Advanced HF
HFrEF(100%)
25.6 ± 6.4
100454 ± 186 daysFP65%a biological syndrome defined as a decreased homeostatic reserve leading to an increased vulnerability to stressors and adverse outcomes

Pulignano
2016
Italy
331
78.0±5.2
42.30
chronic HF
HFpEF (19.9%)
34.6±11.6
51.41yearGait speed34.7%
(⩽0.65 m/s)
a syndrome of loss of reserves that enhances vulnerability to stressors (e.g., concomitant acute illnesses, hospitalizations, medical procedures)

Abbreviations: EF, Ejection Fraction; FP, Frailty Phenotype; FSS, Frailty Staging System; HF, heart failure; HFpEF, Heart Failure preserved Ejection Fraction; HFrEF, Heart Failure reduced Ejection Fraction; M, mean; N, number; NR, no report; NYHA, New York Heart Association; SD, standard deviation; SPPB, Short Physical Performance Battery; USA, United States of America.