Frailty evaluation for the prediction of short-term mortality of patients with sepsis: a meta-analysis

Frailty is increasingly recognized as an important determinant of outcomes in critically ill patients. However, its prognostic value for short-term mortality among adults with sepsis remains incompletely defined. We conducted a meta-analysis to evaluate the association between baseline frailty and short-term mortality in patients with sepsis. PubMed, Embase, and Web of Science were searched for longitudinal observational studies enrolling adult patients with sepsis that compared mortality between frail and non-frail individuals. Frailty was assessed using validated instruments before or at hospital/ICU admission. Short-term mortality was defined as in-hospital or 28-/30-day all-cause mortality. Random-effects models were used to pool risk ratios (RRs) with 95% confidence intervals (CIs) accounting for the potential influence of heterogeneity. Twelve studies involving 14,621 patients with sepsis were included, of whom 4577 (31.3%) were classified as frail at baseline. During follow-up, 3068 (21.0%) patients died. Overall, frailty was associated with a significantly higher risk of short-term mortality (RR 1.82, 95% CI 1.45–2.29, p 0.05). Baseline frailty is associated with an approximately 80% higher risk of short-term mortality in adult patients with sepsis. However, the substantial heterogeneity among the included studies warrants cautious interpretation of these findings.