Systematic review and meta-analysis of prevalence, trajectories, and clinical outcomes for frailty in COPD

Hanlon, P. , Guo, X., McGhee, E., Lewsey, J. , McAllister, D. and Mair, F. S. (2023) Systematic review and meta-analysis of prevalence, trajectories, and clinical outcomes for frailty in COPD. npj Primary Care Respiratory Medicine, 33, 1. (doi: 10.1038/s41533-022-00324-5) (PMID:36604427) (PMCID:PMC9816100)

Abstract

This systematic review synthesised measurement and prevalence of frailty in COPD and associations between frailty and adverse health outcomes. We searched Medline, Embase and Web of Science (1 January 2001–8 September 2021) for observational studies in adults with COPD assessing frailty prevalence, trajectories, or association with health-related outcomes. We performed narrative synthesis and random-effects meta-analyses. We found 53 eligible studies using 11 different frailty measures. Most common were frailty phenotype (n = 32), frailty index (n = 5) and Kihon checklist (n = 4). Prevalence estimates varied by frailty definitions, setting, and age (2.6–80.9%). Frailty was associated with mortality (5/7 studies), COPD exacerbation (7/11), hospitalisation (3/4), airflow obstruction (11/14), dyspnoea (15/16), COPD severity (10/12), poorer quality of life (3/4) and disability (1/1). In conclusion, frailty is a common among people with COPD and associated with increased risk of adverse outcomes. Proactive identification of frailty may aid risk stratification and identify candidates for targeted intervention.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: McAllister, Professor David and Hanlon, Dr Peter and Lewsey, Professor Jim and Mair, Professor Frances
• Authors: Hanlon, P., Guo, X., McGhee, E., Lewsey, J., McAllister, D., and Mair, F. S.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > General Practice and Primary Care; College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Health Economics and Health Technology Assessment; College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Public Health
• Journal Name: npj Primary Care Respiratory Medicine
• Publisher: Nature Research
• ISSN: 2055-1010
• ISSN (Online): 2055-1010
• Copyright Holders: Copyright © 2023 The Authors
• First Published: First published in npj Primary Care Respiratory Medicine 33: 1
• Publisher Policy: Reproduced under a Creative Commons License

Project Code	Award No	Project Name	Principal Investigator	Funder's Name	Funder Ref	Lead Dept
305232		Understanding prevalence and impact of frailty in chronic illness and implications for clinical management	Frances Mair	Medical Research Council (MRC)	MR/S021949/1	HW - General Practice and Primary Care