机构:[1]Chinese Univ Hong Kong, Fac Med, Dept Med & Therapeut, Hong Kong, Hong Kong, Peoples R China;[2]Chinese Univ Hong Kong, Fac Med, Li Ka Shing Inst Hlth Sci, Hong Kong, Hong Kong, Peoples R China;[3]Tianjin Med Univ, Tianjin Key Lab Ion Mol Funct Cardiovasc Dis, Tianjin Inst Cardiol, Hosp 2,Dept Cardiol, 23 Pingjiang Rd, Tianjin 300211, Peoples R China;[4]Univ Valencia, Hosp Clin Univ, INCLIVA, Cardiol Dept,Dept Med, Valencia, Spain;[5]CIBER Cardiovasc Dis CIBERCV, Madrid, Spain;[6]Shahid Sadoughi Univ Med Sci, Cardiovasc Res Ctr, Yazd, Iran;[7]Chinese Univ Hong Kong, Sch Life Sci, Hong Kong, Hong Kong, Peoples R China;[8]Chinese Univ Hong Kong, State Key Lab Digest Dis, Dept Anesthesia & Intens Care, Hong Kong, Hong Kong, Peoples R China;[9]Evangelismos Gen Hosp Athens, Dept Cardiol 2, Lab Cardiac Electrophysiol, Athens, Greece;[10]Lankenau Inst Med Res, Wynnewood, PA USA;[11]Lankenau Med Ctr, Wynnewood, PA USA;[12]Capital Med Univ, Beijing Anzhen Hosp, Beijing, Peoples R China;首都医科大学附属安贞医院[13]Queens Univ, Kingston Gen Hosp, Dept Med, Kingston, ON, Canada;[14]Chinese Univ Hong Kong, JC Sch Publ Hlth & Primary Care, Div Occupat & Environm Hlth, Hong Kong, Hong Kong, Peoples R China;[15]Dalian Med Univ, Affiliated Hosp 1, Dept Cardiovasc Med, Dalian, Peoples R China内科科室心内科大连医科大学附属第一医院
Background: Frailty has been identified as a risk factor for mortality. However, whether frailty increases mortality risk in patients undergoing percutaneous coronary intervention (PCI) has been controversial. Therefore, we conducted a systematic review and meta-analysis of the frailty measures and mortality outcomes in this setting. Methods: PubMed and EMBASE were searched until July 23, 2017 for studies evaluating the association between frailty measures and mortality in individuals who have undergone PCI. Results: A total of 141 entries were retrieved from our search strategy. A total of 8 studies involving 2332 patients were included in the final meta-analysis (mean age: 69 years; 68% male, follow-up duration was 30 + 28 months). Frailty was a significant predictor of all-cause mortality after PCI, with a hazard ratio (HR) of 2.97 [95% confidence interval (CI) 1.56-5.66, P =.001]. This was substantial heterogeneity present (I-2: 79%). Subgroup analysis using the Fried score reduced I-2 to 68% without altering the pooled HR (2.78, 95% CI 1.02-7.76; P <.05). Using the Canadian Study of Health and Aging Clinical Frailty Scale reduced I-2 to 0% while preserving the pooled HR (5.99, 95% CI 2.77-12.95, P <.001). Conclusions: Frailty leads to significantly higher mortality rates in patients who have undergone PCI. Both the Fried score and Canadian Study of Health and Aging Clinical Frailty Scale are powerful predictors of mortality. These findings may support the notion that an alternative to invasive strategy should be considered in frail patients who are indicated for revascularization. (C) 2017 Published by Elsevier Inc. on behalf of AMDA - The Society for Post-Acute and Long-Term Care Medicine.
第一作者机构:[1]Chinese Univ Hong Kong, Fac Med, Dept Med & Therapeut, Hong Kong, Hong Kong, Peoples R China;[2]Chinese Univ Hong Kong, Fac Med, Li Ka Shing Inst Hlth Sci, Hong Kong, Hong Kong, Peoples R China;
通讯作者:
通讯机构:[3]Tianjin Med Univ, Tianjin Key Lab Ion Mol Funct Cardiovasc Dis, Tianjin Inst Cardiol, Hosp 2,Dept Cardiol, 23 Pingjiang Rd, Tianjin 300211, Peoples R China;
推荐引用方式(GB/T 7714):
Tse Gary,Gong Mengqi,Nunez Julia,et al.Frailty and Mortality Outcomes After Percutaneous Coronary Intervention: A Systematic Review and Meta-Analysis[J].JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION.2017,18(12):-.doi:10.1016/j.jamda.2017.09.002.
APA:
Tse, Gary,Gong, Mengqi,Nunez, Julia,Sanchis, Juan,Li, Guangping...&Woo, Jean.(2017).Frailty and Mortality Outcomes After Percutaneous Coronary Intervention: A Systematic Review and Meta-Analysis.JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION,18,(12)
MLA:
Tse, Gary,et al."Frailty and Mortality Outcomes After Percutaneous Coronary Intervention: A Systematic Review and Meta-Analysis".JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION 18..12(2017):-