衰弱与非心血管手术心力衰竭患者结局的Meta分析  

Frailty and clinical outcomes in non-cardiovascular surgery heart failure patients: a meta-analysis

作　　者：王柄茜 顾宁[2] WANG Bingqian;GU Ning(Nanjing University of Traditional Chinese Medicine,Nanjing 210046,P.R.China;Department of Cardiology,Nanjing Hospital of Traditional Chinese Medicine of Nanjing University of Traditional Chinese Medicine,Nanjing 210022,P.R.China)

机构地区：[1]南京中医药大学,南京210046 [2]南京中医药大学附属南京中医院心血管科,南京210022

出　　处：《中国循证医学杂志》2022年第4期394-402,共9页Chinese Journal of Evidence-based Medicine

基　　金：第二批江苏省中医药领军人才培养项目(编号:苏中医科教[2018]4号)。

摘　　要：目的 系统评价衰弱对非心血管手术心力衰竭患者预后的影响。方法 计算机检索CNKI、VIP、CBM、WanFang Data、PubMed、EMbase、Web of Science和The Cochrane Library数据库,搜集关于衰弱对非心血管手术心力衰竭患者预后影响的队列研究,检索时限均从建库至2021年11月1日。由2名研究者独立筛选文献,提取资料并评价纳入研究的偏倚风险后,采用RevMan 5.3软件和Stata 14.0软件进行Meta分析。结果 共纳入20个研究,包括11 127例患者。Meta分析结果显示:衰弱增加非心血管手术心力衰竭患者全因死亡[HR=1.72,95%CI(1.61,1.84),P<0.000 01]、住院[HR=2.06,95%CI(1.26,3.37),P=0.004]和联合终点风险[HR=1.59,95%CI(1.37,1.84),P<0.000 01]。结论 当前证据表明,衰弱可增加非心血管手术心力衰竭患者全因死亡、住院、联合终点风险。受纳入研究数量和质量限制,上述结论尚需开展更多高质量研究予以验证。Objective To systematically review the influence of frailty on the prognosis of non-cardiovascular surgery heart failure(HF) patients and to provide references for its prevention and management. Methods CNKI, VIP,CBM, WanFang Data, PubMed, EMbase, Web of Science, and The Cochrane Library were searched to collect cohort studies on the prognosis of non-cardiovascular surgery HF patients with frailty from inception to November 1st, 2021. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of the included studies. Then,meta-analysis was performed using RevMan 5.3 software and Stata 14.0 software. Results A total of 20 studies involving 11 127 patients were included. The results of meta-analysis showed that frailty increased the risk of all-cause mortality(HR=1.72, 95%CI 1.61 to 1.84, P<0.000 01), hospitalization(HR=2.06, 95%CI 1.26 to 3.37, P=0.004), and combined endpoint(HR=1.59, 95%CI 1.37 to 1.84, P<0.000 01) in non-cardiovascular surgery HF patients. Conclusion Current evidence shows that frailty can increase the risk of all-cause mortality, hospitalization, and combined endpoints in noncardiovascular surgery HF patients. Due to the limited quantity and quality of the included studies, more high-quality studies are needed to verify the above conclusion.

关 键 词：衰弱 心力衰竭 全因死亡 住院 联合终点 META分析 

分 类 号：R541.6[医药卫生—心血管疾病]