What question did this study set out to answer?

To determine the baseline prevalence of frailty in cardiac rehabilitation, assess changes in frailty status during rehabilitation, and evaluate the risk of subsequent adverse clinical outcomes.

July 22, 2024European Journal of Preventive CardiologyOpen Access

Cardiac rehabilitation and frailty: a systematic review and meta-analysis

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Why the study?

Frailty among cardiac rehabilitation participants is linked to worse outcomes, but no synthesis had quantified the relationship between frailty and cardiac rehabilitation outcomes.

Does cardiac rehabilitation improve frailty, and is baseline frailty associated with adverse outcomes in cardiac rehabilitation participants?

Population

19 360 participants across 34 studies in cardiac rehabilitation

Comparison

Frailty status and changes during cardiac rehabilitation

Design

Systematic review and meta-analysis of 26 observational studies and 8 randomized trials

Authors

EMEvan MacEachernDalhousie University JQJack QuachDalhousie University NGNicholas GiacomantonioDalhousie University

Discussion

Member takes

Implication

Cardiac rehabilitation programs should incorporate frailty screening; extends evidence for CR benefits to high-risk frail patients.

Key Points

To determine the baseline prevalence of frailty in cardiac rehabilitation, assess changes in frailty status during rehabilitation, and evaluate the risk of subsequent adverse clinical outcomes.
Systematic search of CINAHL, EMBASE, and MEDLINE (2000–2023) identifying 34 peer-reviewed studies (26 observational, 8 randomized trials; N=19,360) employing validated frailty tools.
Inverse variance random-effects meta-analyses were performed separately for observational cohorts and randomized trials to evaluate frailty prevalence, functional changes, and survival outcomes.
Baseline frailty prevalence was 46% (95% CI 29–62%) using the Frailty Index and Kihon Checklist (14 studies) and 40% (95% CI 28–52%) using the Frailty Phenotype (11 studies).
Participation in cardiac rehabilitation significantly reduced frailty (standardized mean difference: 0.68, 95% CI 0.37–0.99; P < 0.0001; 6 studies).
Frailty at admission was associated with a marked increase in all-cause mortality during post-rehabilitation follow-up (HR: 9.24, 95% CI 2.93–29.16; P = 0.0001; 4 studies).

Structured PICO

Does cardiac rehabilitation improve frailty, and is baseline frailty associated with adverse outcomes in cardiac rehabilitation participants?

Population

19,360 participants across 34 studies (26 observational, 8 randomized trials) participating in cardiac rehabilitation.

Intervention

Cardiac rehabilitation (CR)

Outcome

Frailty prevalence at CR admission, frailty and physical function changes, and post-CR hospitalization and mortalityhard clinical

Frailty is highly prevalent among cardiac rehabilitation participants and is associated with increased mortality, but cardiac rehabilitation effectively improves frailty and physical health outcomes.

Limitations

High variability in frailty tools and CR designs
Randomized controlled trial contributions were limited

Cite This Study

MacEachern et al. (2024) studied this question.

synapsesocial.com/papers/6a03675cf32c10a08381eb38 https://doi.org/10.1093/eurjpc/zwae239

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Cardiac rehabilitation and frailty: a systematic review and meta-analysis

Discussion

Member takes

Implication

Key Points

Structured PICO

Limitations

Cite This Study

Cardiac rehabilitation and frailty: a systematic review and meta-analysis

Discussion

Member takes

Implication

Key Points

Structured PICO

Limitations

Cite This Study

Also Consider

Also Consider