Prevalence and clinical impact of frailty in COPD：A Systematic Review and Meta-analysis

Abstract

Background: Frailty has been increasingly identified as a risk factor of adverse outcomes in chronic obstructive pulmonary disease (COPD). The prevalence and impact of frailty on health outcomes in people with COPD require clarification. Methods: PubMed, Embase, The Cochrane Library and Web of Science (January 1, 2002, to July 1, 2022) were comprehensively searched to identify studies related to frailty and COPD. Comparisons were made between people who did and did not have frailty for pulmonary function, dyspnea severity, 6-minute walking distance, activities of daily life, and mortality. Results: Twenty studies (8 cross-sectional, 6 prospective, 5 retrospective cohort,1 clinical trial) from Europe (9), Asia (6), and North and South America (4), Oceania (1) involving 11, 620 participants were included. The prevalence of frailty ranged from 6.43% to 71.7% based on the frailty tool used. Overall sarcopenia prevalence varied from 32.07% (95% confidence interval (CI) 26.64–37.49). People with frailty had lower predicted forced expiratory volume in the first second (mean difference -5.06%; 95%CI -6.70 to -3.42%)，shorter 6-minute walking distance (mean difference -90.23 meter; 95%CI -124.70 to -55.76), poorer activities of daily life (standardized mean difference -0.99; 95%CI -1.35 to -0.62) , higher CAT score(mean difference 6.2; 95%CI 4.43 to 7.96) and mMRC grade (mean difference 0.93; 95%CI 0.85 to 1.02) compared with those who did not (P < 0.001 for all). Meta-analysis showed that frailty was associated with an increased risk of long-term all-cause mortality (HR 1.68; 95% CI 1.37-2.05; I2=0%, p < 0.00, Tau-squared=0). Conclusion: Frailty is prevalent in people with COPD and associates with negative clinical outcomes including pulmonary function, dyspnea severity, exercise capacity, quality of life and mortality.

Development of the Readiness for Hospital Discharge Scale for Patients with Bile Duct Carcinoma Catheterized After Percutaneous Transhepatic Cholangial Drainage: A Validity and Reliability Study

“…We used the independent sample t-test to determine their corresponding critical ratios, with the critical ratio < 3.0 as the deletion criteria; 2) Correlation coefficient method: We analyzed the correlation between the item and the scale score, with the correlation coefficient < 0.4 as the deletion criteria; 22 Cronbach's α coefficient method: If the total score had a relatively higher Cronbach's α coefficient after an item was deleted, this suggested that the attribute of the item to be measured in the scale was different from that of other items, and was deleted; 23 4) Factor analysis: This involved two indicators, namely "communality" and "factor load based on which we analyzed the relationship between the item and the scale; when the factor load value was <0.4 or common load occurred, the item was deleted. 24 Validity Evaluation 1) Content validity: 10 medical experts from the intervention department or hepatological surgery department were invited to evaluate the content validity. We ensured balance in age, work experience, designation, education level, and other aspects when selecting them.…”