Frailty prevalence in hospitalized older adults

A systematic review

Abstract

Background: Theres is uncertain evidence regarding the prevalence, measurement tools, outcomes, and efficacy of the interventions on frailty in hospitalized older adults. For this reason, we present the results of a systematic review about Frailty and Hospital, following the PRISMA methodology.

Methods: We found 2,050 articles published in PubMed. After an initial assessment of titles and abstracts, complete comprehensive text lecture, and meta-analysis review, we finally included in the systematic review 246 originals.

Results: The main result of the systematic review is that from the 246 articles, 179 described frailty prevalence in hospital older adults, with a pooled prevalence of 41.4% (95% CI 38.4% to 44.4%; range 4.7% to 92.5%). The most frequent type of studies were those observational prospectives 166 (67.5%), being the rest observtcional retrospectives or cross-sectional 64 (26.2%) or randomized clinical trials 15 (6.1%). The most frequent healthcare levels where the studies took place were the Hospital/Hospitalization in 125 (50.8%), Geriatric Department in 41 (16.7%), Surgical Units in 23 (9.3%), Cardiology Department in 18 (7.3%), Emergency Department in 15 (6.1%), and other in 24 (9.8%). The most frequent used measurement tolos were the Clinical Frailty Scale in 69 works (28%), the frailty phenotype in 41 (15.9%), the Frailty Index in 39 (15.9%) and the FRAIL scale in 27 (11.0%).  In several papers, more than one instrument was used, and in many of them, scales and cut-off points were arbitrarely determined, producing a great results heterogeneity.

Conclusions: The prevalence of frailty in hospitalized older adults is very high. It is necessary to improve frailty measure homogenity and to realize randomized clinical trials in this population.