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Impact of frailty on pneumonia outcomes in older patients: a systematic review and meta-analysis

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Key summary points

AbstractSection Aim

To determine the burden and effect of frailty on selected clinical outcomes among older patients with pneumonia.

AbstractSection Findings

Our systematic review and meta-analysis results show that one in every two older individuals with pneumonia present frailty, a condition that significantly influences their rates of mortality and readmission, and their hospital stay length.

AbstractSection Message

The integration of geriatric principles into pneumonia management, including functional assessments, nutritional support, and multidisciplinary care, is pivotal to optimize outcomes in this vulnerable population.

Abstract

Purpose

The ideal method for identifying frailty remains unclear, but the condition is associated with poor prognoses in many illnesses. Despite the availability of studies, the prognostic implications of frailty on older patients with pneumonia remains unexplored. To determine the burden and effect of frailty on selected clinical outcomes among older patients with pneumonia.

Methods

We searched Medline, Google Scholar, and Science Direct databases for articles published in English following the PRISMA framework to guide our review. We included studies conducted on patients (> 60 years) with frailty and pneumonia, and reporting the effect of frailty on mortality, hospital stay, length readmission, and ICU admission. We performed a meta-analysis using STATA 14.2, calculating pooled odds ratios and 95% confidence intervals.

Results

We analysed data from 16 studies and calculated a pooled frailty prevalence of 49% (95% CI 37–60%) in older patients with pneumonia. Unadjusted analyses revealed an odds ratio (OR) of 2.50 (95% CI 1.88–3.32) for the intermediate risk group, and an OR of 3.51 (95% CI 3.05–4.05) for the high risk group regarding mortality. The high risk frailty group also exhibited significant elevations in the risk of readmissions and extended hospital stay lengths. Substantial heterogeneity was observed in both adjusted and unadjusted analyses.

Conclusions

Our systematic review and meta-analysis results show that one in every two older individuals with pneumonia present frailty, a condition that significantly influences their rates of mortality and readmission, and their hospital stay length.

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Data availability

The data used for the analysis is taken from sources that are free and publicly available [Platforms: PubMed, Science direct and Google scholar]. The data sheet can be shared on resonable request from readers.

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Authors and Affiliations

  1. Huzhou Third Municipal Hospital, the Affiliated Hospital of Huzhou University, No. 2088 Tiaoxi East Road, Huzhou, Zhejiang, China

    Yanlan Yang & Ying Zhong

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  1. Yanlan Yang
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Contributions

YY and YZ performed the study conception, design, material preparation, data collection, and data analysis. YZ wrote the first draft of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Ying Zhong.

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Yang, Y., Zhong, Y. Impact of frailty on pneumonia outcomes in older patients: a systematic review and meta-analysis. Eur Geriatr Med (2024). https://doi.org/10.1007/s41999-024-00974-3

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