老年心力衰竭病人衰弱危险因素的Meta分析OA

Objective:To identify the risk factors of frailty in elderly patients with heart failure through a Meta-analysis,and provide scientific basis for interventions to prevent frailty in elderly patients with heart failure.Methods:The studies on risk factors of frailty in elderly patients with heart failure were systematically searched from PubMed,CINAHL,Web of Science,the Cochrane Library,China National Knowledge Infrastructure,WanFang Data and VIP.The retrieval period was from establishment of databases to February 28,2023.Two independent reviewers screened the literature,evaluated the bias risk of the included studies,and extracted data according to inclusion and exclusion criteria.A third party judged the research differences.RevMan 5.3 software was used for Meta-analysis.Results:Sixteen studies were finally included,including one case-control study and 15 cross-sectional studies.A total of 3 622 heart failure patients were included,of which 2 401 were frail,involving 10 influencing factors.Meta-analysis results showed that the incidence of frailty in elderly patients with heart failure was 63％[95％CI(0.53,0.73),P＜0.001],and the risk factors for frailty in elderly patients with heart failure were age[OR=1.14,95％CI(1.04,1.25),P＜0.01],New York Heart Association cardiac functional grading[OR=2.70,95％CI(1.57,4.64),P＜0.01],polypharmacy[OR=2.40,95％CI(1.42,4.04),P＜0.01],and left atrial diameter[OR=2.05,95％CI(1.91,2.20),P＜0.01].Sensitivity analysis showed changes in combined effects of serum creatinine,ejection fraction,Charlson Comorbidity Index,and hemoglobin under two models,publication bias was significant.Conclusions:The incidence of frailty in elderly heart failure patients is high and there are many influencing factors.Early assessment and intervention should be carried out for frailty-related risk factors to reduce the adverse effects of frailty on heart failure patients and improve their quality of life.