Prevalencia de fragilidad en adultos mayores hospitalizados. Revisión sistemática

e202110158

Autores/as

  • Elena Gómez Jiménez Servicio de Geriatría. Complejo Hospitalario Universitario de Albacete. Albacete. España.
  • Almudena Avendaño Céspedes Servicio de Geriatría. Complejo Hospitalario Universitario de Albacete. Albacete. España. / CIBER de Fragilidad y Envejecimiento Saludable (CIBERFES). España. / Facultad de Enfermería de Albacete. Universidad de Castilla-La Mancha. Albacete. España.
  • Elisa Belén Cortés Zamora Servicio de Geriatría. Complejo Hospitalario Universitario de Albacete. Albacete. España. / CIBER de Fragilidad y Envejecimiento Saludable (CIBERFES). España.
  • Rafael García Molina Servicio de Geriatría. Complejo Hospitalario Universitario de Albacete. Albacete. España.
  • Pedro Abizanda Servicio de Geriatría. Complejo Hospitalario Universitario de Albacete. Albacete. España. / CIBER de Fragilidad y Envejecimiento Saludable (CIBERFES). España. / Facultad de Medicina de Albacete. Universidad de Castilla-La Mancha. Albacete. España.

Palabras clave:

Fragilidad, Hospital, Adulto mayor

Resumen

Fundamentos: Existe escasa evidencia sobre la prevalencia, herramientas de medición, resultados de salud y eficacia de las intervenciones sobre la fragilidad en adultos mayores en medio hospitalario. Por ello, presentamos los resultados de una revisión sistemática de la Fragilidad en adultos mayores en medio hospitalario, siguiendo la metodología de la declaración PRISMA.
Métodos: Se encontraron 2.050 artículos en PubMed. Tras la valoración inicial de los títulos y resúmenes, lectura de texto completo y revisión de los meta-análisis, al final se incluyeron en la revisión sistemática 246 originales.
Resultados: El principal resultado fue que, de los 246 originales revisados, 179 describían la prevalencia de fragilidad en adultos mayores en el hospital, siendo el porcentaje combinado del 41,4% (IC 95% 38,4% a 44,4%; rango 4,7% a 92,5%). Por tipo de estudios predominaron los observacionales prospectivos 166 (67,5%), observacionales retrospectivos o transversales 64 (26,2%) y ensayos clínicos 15 (6,1%). Los dispositivos asistenciales más frecuentes fueron el Hospital en general/Hospitalización 125 (50,8%), Geriatría 41 (16,7%), Unidades quirúrgicas 23 (9,3%), Cardiología 18 (7,3%), Urgencias/emergencias 15 (6,1%) y otros dispositivos médicos 24 (9,8%). Las herramientas de valoración de la fragilidad más empleadas fueron la Clinical Frailty Scale en 69 artículos (28%), fenotipo de fragilidad en 41 (16,7%), Frailty Index en 39 (15,9%) y herramienta FRAIL en 27 (11,0%). En varios artículos se emplearon dos o más de las herramientas descritas, y en muchos, las escalas y los puntos de corte fueron arbitrariamente modificados por los autores, generando una gran heterogeneidad en los resultados.
Conclusiones: La prevalencia de fragilidad en adultos mayores en el hospital es muy alta, pero es necesaria una mayor uniformidad en su medición y la implementación de ensayos clínicos para evaluar
intervenciones.

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Anexo I:

Bibliografía de los

estudios seleccionados

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Gu JJ, Liu Q, Zheng LJ. A Frailty Assessment Tool to Predict In-Hospital Mortality in Patients with Acute Exacerbations of Chronic Obstructive Pulmonary Disease. Int J Chron Obstruct Pulmon Dis. 2021 Apr 20;16:1093-1100. doi: 10.2147/COPD.S300980. PMID: 33907395; PMCID: PMC8068494.

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Yang Y, Hao Q, Flaherty JH, Cao L, Zhou J, Su L, Shen Y, Dong B. Comparison of procalcitonin, a potentially new inflammatory biomarker of frailty, to interleukin-6 and C-reactive protein among older Chinese hospitalized patients. Aging Clin Exp Res. 2018 Dec;30(12):1459-1464. doi: 10.1007/s40520-018-0964-3. Epub 2018 May 17. PMID: 29777476.

Morton S, Isted A, Avery P, Wang J. Is Frailty a Predictor of Outcomes in Elderly Inpatients with Acute Kidney Injury? A Prospective Cohort Study. Am J Med. 2018 Oct;131(10):1251-1256.e2. doi: 10.1016/j.amjmed.2018.03.012. Epub 2018 Apr 4. PMID: 29626429.

Llaó I, Ariza-Solé A, Sanchis J, Alegre O, López-Palop R, Formiga F, Marín F, Vidán MT, Martínez-Sellés M, Sionis A, Vives-Borrás M, Gómez-Hospital JA, Gómez-Lara J, Roura G, Díez-Villanueva P, Núñez-Gil I, Maristany J, Asmarats L, Bueno H, Abu-Assi E, Cequier À. Invasive strategy and frailty in very elderly patients with acute coronary syndromes. EuroIntervention. 2018 Jun 8;14(3):e336-e342. doi: 10.4244/EIJ-D-18-00099. PMID: 29616624.

McGuckin DG, Mufti S, Turner DJ, Bond C, Moonesinghe SR. The association of peri-operative scores, including frailty, with outcomes after unscheduled surgery. Anaesthesia. 2018 Jul;73(7):819-824. doi: 10.1111/anae.14269. Epub 2018 Mar 23. PMID: 29569398.

Li Y, Pederson JL, Churchill TA, Wagg AS, Holroyd-Leduc JM, Alagiakrishnan K, Padwal RS, Khadaroo RG. Impact of frailty on outcomes after discharge in older surgical patients: a prospective cohort study. CMAJ. 2018 Feb 20;190(7):E184-E190. doi: 10.1503/cmaj.161403. PMID: 29565018; PMCID: PMC5828889.

Pasqualetti G, Calsolaro V, Bernardini S, Linsalata G, Bigazzi R, Caraccio N, Monzani F. Degree of Peripheral Thyroxin Deiodination, Frailty, and Long-Term Survival in Hospitalized Older Patients. J Clin Endocrinol Metab. 2018 May 1;103(5):1867-1876. doi: 10.1210/jc.2017-02149. PMID: 29546287.

Yang F, Chen QW. Evaluation of frailty and influencing factors in old people in hospital institution: Evidence for a phenotype of frailty. Medicine (Baltimore). 2018 Jan;97(3):e9634. doi: 10.1097/MD.0000000000009634. PMID: 29504994; PMCID: PMC5779763.

Schoenenberger AW, Moser A, Bertschi D, Wenaweser P, Windecker S, Carrel T, Stuck AE, Stortecky S. Improvement of Risk Prediction After Transcatheter Aortic Valve Replacement by Combining Frailty With Conventional Risk Scores. JACC Cardiovasc Interv. 2018 Feb 26;11(4):395-403. doi: 10.1016/j.jcin.2017.11.012. PMID: 29471953.

Andreasen J, Aadahl M, Sørensen EE, Eriksen HH, Lund H, Overvad K. Associations and predictions of readmission or death in acutely admitted older medical patients using self-reported frailty and functional measures. A Danish cohort study. Arch Gerontol Geriatr. 2018 May-Jun;76:65-72. doi: 10.1016/j.archger.2018.01.013. Epub 2018 Feb 13. PMID: 29462759.

Chong E, Chan M, Lim WS, Ding YY. Frailty Predicts Incident Urinary Incontinence Among Hospitalized Older Adults-A 1-Year Prospective Cohort Study. J Am Med Dir Assoc. 2018 May;19(5):422-427. doi: 10.1016/j.jamda.2017.12.103. Epub 2018 Feb 10. PMID: 29439853.

Rogers T, Alraies MC, Moussa Pacha H, Bond E, Buchanan KD, Steinvil A, Gai J, Torguson R, Ben-Dor I, Satler LF, Waksman R. Clinical Frailty as an Outcome Predictor After Transcatheter Aortic Valve Implantation. Am J Cardiol. 2018 Apr 1;121(7):850-855. doi: 10.1016/j.amjcard.2017.12.035. Epub 2018 Jan 11. PMID: 29422352.

Ondeck NT, Bovonratwet P, Ibe IK, Bohl DD, McLynn RP, Cui JJ, Baumgaertner MR, Grauer JN. Discriminative Ability for Adverse Outcomes After Surgical Management of Hip Fractures: A Comparison of the Charlson Comorbidity Index, Elixhauser Comorbidity Measure, and Modified Frailty Index. J Orthop Trauma. 2018 May;32(5):231-237. doi: 10.1097/BOT.0000000000001140. PMID: 29401098.

Amblàs-Novellas J, Martori JC, Espaulella J, Oller R, Molist-Brunet N, Inzitari M, Romero-Ortuno R. Frail-VIG index: a concise frailty evaluation tool for rapid geriatric assessment. BMC Geriatr. 2018 Jan 26;18(1):29. doi: 10.1186/s12877-018-0718-2. PMID: 29373968; PMCID: PMC5787254.

Fallon A, Kilbane L, Briggs R, Dyer A, Nabeel S, McElwaine P, Collins R, Coughlan T, O’Neill D, Ryan D, Kennelly SP. Screening for frailty in older emergency department patients: the utility of the Survey of Health, Ageing and Retirement in Europe Frailty Instrument. QJM. 2018 Mar 1;111(3):151-154. doi: 10.1093/qjmed/hcx242. PMID: 29237068.

Brousseau AA, Dent E, Hubbard R, Melady D, Émond M, Mercier É, Costa AP; Multinational Emergency Department Study. Identification of older adults with frailty in the Emergency Department using a frailty index: results from a multinational study. Age Ageing. 2018 Mar 1;47(2):242-248. doi: 10.1093/ageing/afx168. PMID: 29165543.

Alegre O, Formiga F, López-Palop R, Marín F, Vidán MT, Martínez-Sellés M, Carol A, Sionis A, Díez-Villanueva P, Aboal J, Palau-Vendrel A, Bueno H, Rivera AP, Sanchís J, Abu-Assi E, Corbí M, Castillo JC, Bañeras J, González-Salvado V, Cequier À, Ariza-Solé A; LONGEVO-SCA registry investigators. An Easy Assessment of Frailty at Baseline Independently Predicts Prognosis in Very Elderly Patients With Acute Coronary Syndromes. J Am Med Dir Assoc. 2018 Apr;19(4):296-303. doi: 10.1016/j.jamda.2017.10.007. Epub 2017 Nov 17. PMID: 29153753.

Chong E, Ho E, Baldevarona-Llego J, Chan M, Wu L, Tay L, Ding YY, Lim WS. Frailty in Hospitalized Older Adults: Comparing Different Frailty Measures in Predicting Short- and Long-term Patient Outcomes. J Am Med Dir Assoc. 2018 May;19(5):450-457.e3. doi: 10.1016/j.jamda.2017.10.006. Epub 2017 Nov 15. PMID: 29153536.

Lin H, Peel NM, Scott IA, Vardesh DL, Sivalingam P, McBride RL, Morong JJ, Nelson MJ, Hubbard RE. Perioperative assessment of older surgical patients using a frailty index-feasibility and association with adverse post-operative outcomes. Anaesth Intensive Care. 2017 Nov;45(6):676-682. doi: 10.1177/0310057X1704500605. PMID: 29137576.

Bernal E, Bayés-Genís A, Ariza-Solé A, Formiga F, Vidán MT, Escobar-Robledo LA, Aboal J, Alcoberro L, Guerrero C, Ariza-Segovia I, Hernández de Benito A, Vilardell P, Sánchez-Salado JC, Lorente V, Bayés de Luna A, Martinez-Sellés M. Interatrial block, frailty and prognosis in elderly patients with myocardial infarction. J Electrocardiol. 2018 Jan-Feb;51(1):1-7. doi: 10.1016/j.jelectrocard.2017.08.026. Epub 2017 Sep 1. Erratum in: J Electrocardiol. 2018 Apr 18;: PMID: 28969847.

Flaatten H, De Lange DW, Morandi A, Andersen FH, Artigas A, Bertolini G, Boumendil A, Cecconi M, Christensen S, Faraldi L, Fjølner J, Jung C, Marsh B, Moreno R, Oeyen S, Öhman CA, Pinto BB, Soliman IW, Szczeklik W, Valentin A, Watson X, Zaferidis T, Guidet B; VIP1 study group. The impact of frailty on ICU and 30-day mortality and the level of care in very elderly patients (≥ 80 years). Intensive Care Med. 2017 Dec;43(12):1820-1828. doi: 10.1007/s00134-017-4940-8. Epub 2017 Sep 21. PMID: 28936626.

Vu HTT, Nguyen TX, Nguyen TN, Nguyen AT, Cumming R, Hilmer S, Pham T. Prevalence of frailty and its associated factors in older hospitalised patients in Vietnam. BMC Geriatr. 2017 Sep 15;17(1):216. doi: 10.1186/s12877-017-0609-y. PMID: 28923012; PMCID: PMC5603186.

Warnier RMJ, van Rossum E, van Kuijk SMJ, Mulder WJ, Schols JMGA, Kempen GIJM. The Maastricht Frailty Screening Tool for Hospitalised Patients (MFST-HP) to Identify Non-Frail Patients. Int J Clin Pract. 2017 Sep;71(9). doi: 10.1111/ijcp.13003. Epub 2017 Sep 8. PMID: 28885763.

Rodrigues MK, Marques A, Lobo DML, Umeda IIK, Oliveira MF. Pre-Frailty Increases the Risk of Adverse Events in Older Patients Undergoing Cardiovascular Surgery. Arq Bras Cardiol. 2017 Oct;109(4):299-306. doi: 10.5935/abc.20170131. Epub 2017 Sep 4. PMID: 28876376; PMCID: PMC5644209.

Alonso Salinas GL, Sanmartin M, Pascual Izco M, Rincon LM, Pastor Pueyo P, Marco Del Castillo A, Garcia Guerrero A, Caravaca Perez P, Recio-Mayoral A, Camino A, Jimenez-Mena M, Zamorano JL. Frailty is an independent prognostic marker in elderly patients with myocardial infarction. Clin Cardiol. 2017 Oct;40(10):925-931. doi: 10.1002/clc.22749. Epub 2017 Jul 16. PMID: 28712144; PMCID: PMC6490378.

Chew J, Lim WS, Chong MS, Ding YY, Tay L. Impact of frailty and residual subsyndromal delirium on 1-year functional recovery: A prospective cohort study. Geriatr Gerontol Int. 2017 Dec;17(12):2472-2478. doi: 10.1111/ggi.13108. Epub 2017 Jun 22. PMID: 28639340.

Chong E, Ho E, Baldevarona-Llego J, Chan M, Wu L, Tay L. Frailty and Risk of Adverse Outcomes in Hospitalized Older Adults: A Comparison of Different Frailty Measures. J Am Med Dir Assoc. 2017 Jul 1;18(7):638.e7-638.e11. doi: 10.1016/j.jamda.2017.04.011. Epub 2017 Jun 3. PMID: 28587850.

Hubbard RE, Peel NM, Samanta M, Gray LC, Mitnitski A, Rockwood K. Frailty status at admission to hospital predicts multiple adverse outcomes. Age Ageing. 2017 Sep 1;46(5):801-806. doi: 10.1093/ageing/afx081. PMID: 28531254.

Induruwa I, Evans NR, Aziz A, Reddy S, Khadjooi K, Romero-Ortuno R. Clinical frailty is independently associated with non-prescription of anticoagulants in older patients with atrial fibrillation. Geriatr Gerontol Int. 2017 Nov;17(11):2178-2183. doi: 10.1111/ggi.13058. Epub 2017 Apr 18. PMID: 28418196.

Nguyen TN, Morel-Kopp MC, Pepperell D, Cumming RG, Hilmer SN, Ward CM. The impact of frailty on coagulation and responses to warfarin in acute older hospitalised patients with atrial fibrillation: a pilot study. Aging Clin Exp Res. 2017 Dec;29(6):1129-1138. doi: 10.1007/s40520-017-0733-8. Epub 2017 Mar 2. PMID: 28255906.

Bertoli A, Valentini A, Cianfarani MA, Gasbarra E, Tarantino U, Federici M. Low FT3: a possible marker of frailty in the elderly. Clin Interv Aging. 2017 Feb 10;12:335-341. doi: 10.2147/CIA.S125934. PMID: 28228654; PMCID: PMC5312686.

Sze S, Zhang J, Pellicori P, Morgan D, Hoye A, Clark AL. Prognostic value of simple frailty and malnutrition screening tools in patients with acute heart failure due to left ventricular systolic dysfunction. Clin Res Cardiol. 2017 Jul;106(7):533-541. doi: 10.1007/s00392-017-1082-5. Epub 2017 Feb 15. PMID: 28204965.

Hatheway OL, Mitnitski A, Rockwood K. Frailty affects the initial treatment response and time to recovery of mobility in acutely ill older adults admitted to hospital. Age Ageing. 2017 Nov 1;46(6):920-925. doi: 10.1093/ageing/afw257. PMID: 28104595.

Amblàs-Novellas J, Martori JC, Molist Brunet N, Oller R, Gómez-Batiste X, Espaulella Panicot J. Índice frágil-VIG: diseño y evaluación de un índice de fragilidad basado en la Valoración Integral Geriátrica [Frail-VIG index: Design and evaluation of a new frailty index based on the Comprehensive Geriatric Assessment]. Rev Esp Geriatr Gerontol. 2017 May-Jun;52(3):119-127. Spanish. doi: 10.1016/j.regg.2016.09.003. Epub 2016 Oct 28. PMID: 28029467.

Kajsa E, Katarina W, Sten L, Synneve ID. Screening for frailty among older emergency department visitors: Validation of the new FRESH-screening instrument. BMC Emerg Med. 2016 Jul 22;16(1):27. doi: 10.1186/s12873-016-0087-0. PMID: 27449526; PMCID: PMC4957482.

Hartley P, Adamson J, Cunningham C, Embleton G, Romero-Ortuno R. Clinical frailty and functional trajectories in hospitalized older adults: A retrospective observational study. Geriatr Gerontol Int. 2017 Jul;17(7):1063-1068. doi: 10.1111/ggi.12827. Epub 2016 Jul 18. PMID: 27426434.

Suskind AM, Jin C, Cooperberg MR, Finlayson E, Boscardin WJ, Sen S, Walter LC. Preoperative Frailty Is Associated With Discharge to Skilled or Assisted Living Facilities After Urologic Procedures of Varying Complexity. Urology. 2016 Nov;97:25-32. doi: 10.1016/j.urology.2016.03.073. Epub 2016 Jul 5. PMID: 27392651; PMCID: PMC5477056.

Lorenzon L, Costa G, Massa G, Frezza B, Stella F, Balducci G. The impact of frailty syndrome and risk scores on emergency cholecystectomy patients. Surg Today. 2017 Jan;47(1):74-83. doi: 10.1007/s00595-016-1361-1. Epub 2016 May 30. PMID: 27241560.

Rønning B, Wyller TB, Nesbakken A, Skovlund E, Jordhøy MS, Bakka A, Rostoft S. Quality of life in older and frail patients after surgery for colorectal cancer-A follow-up study. J Geriatr Oncol. 2016 May;7(3):195-200. doi: 10.1016/j.jgo.2016.03.002. Epub 2016 Apr 7. PMID: 27067579.

Mowbray F, Brousseau AA, Mercier E, Melady D, Émond M, Costa AP. Examining the relationship between triage acuity and frailty to inform the care of older emergency department patients: Findings from a large Canadian multisite cohort study. CJEM. 2020 Jan;22(1):74-81. doi: 10.1017/cem.2019.432. PMID: 31718719.

Anexo II:

Referencias de

los 15 meta-análisis

y artículos seleccionados

a partir de ellos

Muscedere J, Waters B, Varambally A, Bagshaw SM, Boyd JG, Maslove D, Sibley S, Rockwood K. The impact of frailty on intensive care unit outcomes: a systematic review and meta-analysis. Intensive Care Med. 2017 Aug;43(8):1105-1122. doi: 10.1007/s00134-017-4867-0. Epub 2017 Jul 4. PMID: 28676896; PMCID: PMC5501903.

1. Heyland D, Cook D, Bagshaw SM, Garland A, Stelfox HT, Mehta S, Dodek P, Kutsogiannis J, Burns K, Muscedere J, Turgeon AF, Fowler R, Jiang X, Day AG; Canadian Critical Care Trials Group; Canadian Researchers at the End of Life Network. The Very Elderly Admitted to ICU: A Quality Finish? Crit Care Med. 2015 Jul;43(7):1352-1360. doi: 10.1097/CCM.0000000000001024. PMID: 25901550.

2. Heyland DK, Garland A, Bagshaw SM, Cook D, Rockwood K, Stelfox HT, Dodek P, Fowler RA, Turgeon AF, Burns K, Muscedere J, Kutsogiannis J, Albert M, Mehta S, Jiang X, Day AG. Recovery after critical illness in patients aged 80 years or older: a multi-center prospective observational cohort study. Intensive Care Med. 2015 Nov;41(11):1911-1920. doi: 10.1007/s00134-015-4028-2. Epub 2015 Aug 26. PMID: 26306719.

3. Zeng A, Song X, Dong J, Mitnitski A, Liu J, Guo Z, Rockwood K. Mortality in Relation to Frailty in Patients Admitted to a Specialized Geriatric Intensive Care Unit. J Gerontol A Biol Sci Med Sci. 2015 Dec;70(12):1586-1594. doi: 10.1093/gerona/glv084. Epub 2015 Sep 22. PMID: 26400736; PMCID: PMC4631107.

Zhang S, Meng H, Chen Q, Wang X, Zou J, Hao Q, Yang M, Wu J. Is frailty a prognostic factor for adverse outcomes in older patients with acute coronary syndrome? Aging Clin Exp Res. 2020 Aug;32(8):1435-1442. doi: 10.1007/s40520-019-01311-6. Epub 2019 Sep 6. PMID: 31489598.

Yang Y, Luo K, Jiang Y, Yu Q, Huang X, Wang J, Liu N, Huang P. The Impact of Frailty on COVID-19 Outcomes: A Systematic Review and Meta-analysis of 16 Cohort Studies. J Nutr Health Aging. 2021;25(5):702-709. doi: 10.1007/s12603-021-1611-9. PMID: 33949641; PMCID: PMC7933604.

1. Marengoni A, Zucchelli A, Grande G, Fratiglioni L, Rizzuto D. The impact of delirium on outcomes for older adults hospitalised with COVID-19. Age Ageing. 2020 Oct 23;49(6):923-926. doi: 10.1093/ageing/afaa189. PMID: 32821901; PMCID: PMC7499475.

King SJ, Raine KA, Peel NM, Hubbard RE. Interventions for frail older inpatients: A systematic review of frailty measures and reported outcomes in randomised controlled trials. Australas J Ageing. 2021 Jun;40(2):129-144. doi: 10.1111/ajag.12951. Epub 2021 Apr 20. PMID: 33876880.

1. Winograd CH, Gerety MB, Lai NA. A negative trial of inpatient geriatric consultation. Lessons learned and recommendations for future research. Arch Intern Med. 1993 Sep 13;153(17):2017-23. PMID: 8357287.

2. Dalleur O, Boland B, Losseau C, Henrard S, Wouters D, Speybroeck N, Degryse JM, Spinewine A. Reduction of potentially inappropriate medications using the STOPP criteria in frail older inpatients: a randomised controlled study. Drugs Aging. 2014 Apr;31(4):291-298. doi: 10.1007/s40266-014-0157-5. PMID: 24566877.

3. Torres-Sánchez I, Valenza MC, Cabrera-Martos I, López-Torres I, Benítez-Feliponi Á, Conde-Valero A. Effects of an Exercise Intervention in Frail Older Patients with Chronic Obstructive Pulmonary Disease Hospitalized due to an Exacerbation: A Randomized Controlled Trial. COPD. 2017 Feb;14(1):37-42. doi: 10.1080/15412555.2016.1209476. Epub 2016 Aug 11. PMID: 27715322.

4. Saltvedt I, Jordhøy M, Opdahl Mo ES, Fayers P, Kaasa S, Sletvold O. Randomised trial of in-hospital geriatric intervention: impact on function and morale. Gerontology. 2006;52(4):223-230. doi: 10.1159/000093654. PMID: 16849865.

5. Saltvedt I, Saltnes T, Mo ES, Fayers P, Kaasa S, Sletvold O. Acute geriatric intervention increases the number of patients able to live at home. A prospective randomized study. Aging Clin Exp Res. 2004 Aug;16(4):300-306. doi: 10.1007/BF03324555. PMID: 15575124.

6. Saltvedt I, Spigset O, Ruths S, Fayers P, Kaasa S, Sletvold O. Patterns of drug prescription in a geriatric evaluation and management unit as compared with the general medical wards: a randomised study. Eur J Clin Pharmacol. 2005 Dec;61(12):921-928. doi: 10.1007/s00228-005-0046-2. Epub 2005 Nov 24. PMID: 16307267.

Zhang XM, Jiao J, Cao J, Huo XP, Zhu C, Wu XJ, Xie XH. Frailty as a predictor of mortality among patients with COVID-19: a systematic review and meta-analysis. BMC Geriatr. 2021 Mar 17;21(1):186. doi: 10.1186/s12877-021-02138-5. PMID: 33731018; PMCID: PMC7968577.

1. Steinmeyer Z, Vienne-Noyes S, Bernard M, Steinmeyer A, Balardy L, Piau A, Sourdet S. Acute Care of Older Patients with COVID-19: Clinical Characteristics and Outcomes. Geriatrics (Basel). 2020 Sep 27;5(4):65. doi: 10.3390/geriatrics5040065. PMID: 32992602; PMCID: PMC7709587.

Han CY, Miller M, Yaxley A, Baldwin C, Woodman R, Sharma Y. Effectiveness of combined exercise and nutrition interventions in prefrail or frail older hospitalised patients: a systematic review and meta-analysis. BMJ Open. 2020 Dec 13;10(12):e040146. doi: 10.1136/bmjopen-2020-040146. PMID: 33318114; PMCID: PMC7737105.

1. Niccoli S, Kolobov A, Bon T, Rafilovich S, Munro H, Tanner K, Pearson T, Lees SJ. Whey Protein Supplementation Improves Rehabilitation Outcomes in Hospitalized Geriatric Patients: A Double Blinded, Randomized Controlled Trial. J Nutr Gerontol Geriatr. 2017 Oct-Dec;36(4):149-165. doi: 10.1080/21551197.2017.1391732. PMID: 29252150.

2. Milte R, Miller MD, Crotty M, Mackintosh S, Thomas S, Cameron ID, Whitehead C, Kurrle S, Ratcliffe J. Cost-effectiveness of individualized nutrition and exercise therapy for rehabilitation following hip fracture. J Rehabil Med. 2016 Apr;48(4):378-385. doi: 10.2340/16501977-2070. PMID: 26998949.

Rezaei-Shahsavarloo Z, Atashzadeh-Shoorideh F, Gobbens RJJ, Ebadi A, Ghaedamini Harouni G. The impact of interventions on management of frailty in hospitalized frail older adults: a systematic review and meta-analysis. BMC Geriatr. 2020 Dec 3;20(1):526. doi: 10.1186/s12877-020-01935-8. PMID: 33272208; PMCID: PMC7712609.

1. Braun T, Grüneberg C, Süßmilch K, Wiessmeier M, Schwenk I, Eggert S, Machleit-Ebner A, Harras I, Thiel C. An augmented prescribed exercise program (APEP) to improve mobility of older acute medical patients - a randomized, controlled pilot and feasibility trial. BMC Geriatr. 2019 Aug 30;19(1):240. doi: 10.1186/s12877-019-1246-4. PMID: 31470815; PMCID: PMC6716827.

2. Ekerstad N, Dahlin Ivanoff S, Landahl S, Östberg G, Johansson M, Andersson D, Husberg M, Alwin J, Karlson BW. Acute care of severely frail elderly patients in a CGA-unit is associated with less functional decline than conventional acute care. Clin Interv Aging. 2017 Aug 8;12:1239-1249. doi: 10.2147/CIA.S139230. PMID: 28848332; PMCID: PMC5557103.

3. Åhlund K, Bäck M, Öberg B, Ekerstad N. Effects of comprehensive geriatric assessment on physical fitness in an acute medical setting for frail elderly patients. Clin Interv Aging. 2017 Nov 13;12:1929-1939. doi: 10.2147/CIA.S149665. PMID: 29180856; PMCID: PMC5691905.

4. Chen CC, Chen CN, Lai IR, Huang GH, Saczynski JS, Inouye SK. Effects of a modified Hospital Elder Life Program on frailty in individuals undergoing major elective abdominal surgery. J Am Geriatr Soc. 2014 Feb;62(2):261-268. doi: 10.1111/jgs.12651. Epub 2014 Jan 17. PMID: 24437990; PMCID: PMC3945439.

5. Ekerstad N, Östberg G, Johansson M, Karlson BW. Are frail elderly patients treated in a CGA unit more satisfied with their hospital care than those treated in conventional acute medical care? Patient Prefer Adherence. 2018 Feb 7;12:233-240. doi: 10.2147/PPA.S154658. PMID: 29445266; PMCID: PMC5808689.

Cosco TD, Best J, Davis D, Bryden D, Arkill S, van Oppen J, Riadi I, Wagner KR, Conroy S. What is the relationship between validated frailty scores and mortality for adults with COVID-19 in acute hospital care? A systematic review. Age Ageing. 2021 May 5;50(3):608-616. doi: 10.1093/ageing/afab008. PMID: 33951151; PMCID: PMC7929406.

1. Warraich HJ, Kitzman DW, Whellan DJ et al. Physical Function, Frailty, Cognition, Depression, and Quality of Life in Hospitalized Adults ≥60 Years With Acute Decompensated Heart Failure With Preserved Versus Reduced Ejection Fraction. Circ Heart Fail 2018;11:e005254.

2. Abramowitz Y, Jilaihawi H, Chakravarty T et al. Impact of Diabetes Mellitus on Outcomes After Transcatheter Aortic Valve Implantation. Am J Cardiol 2016;117:1636-1642.

3. Bell SP, Schnelle J, Nwosu SK et al. Development of a multivariable model to predict vulnerability in older American patients hospitalised with cardiovascular disease. BMJ Open 2015;5:e008122.

4. Costa D, Aladio M, Girado CA, Perez de la Hoz R, Sara Berensztein C. Frailty is independently associated with 1-year mortality after hospitalization for acute heart failure. Int J Cardiol Heart Vasc 2018;21:103-106.

5. Deniz A, Ozmen C, Bayram E, Seydaoglu G, Usal A. Frailty significantly impairs the short term prognosis in elderly patients with heart failure. J Geriatr Cardiol 2018;15:675-681.

6. Dominguez-Rodriguez A, Abreu-Gonzalez P, Jimenez-Sosa A et al. The impact of frailty in older patients with non-ischaemic cardiomyopathy after implantation of cardiac resynchronization therapy defibrillator. Europace 2015;17:598-602.

7. Sokoreli I, Cleland JG, Pauws SC et al. Added value of frailty and social support in predicting risk of 30-day unplanned re-admission or death for patients with heart failure: An analysis from OPERA-HF. Int J Cardiol 2019;278:167-172.

8. Vidan MT, Blaya-Novakova V, Sanchez E, Ortiz J, Serra-Rexach JA, Bueno H. Prevalence and prognostic impact of frailty and its components in non-dependent elderly patients with heart failure. Eur J Heart Fail 2016;18:869-75.

9. Madan SA, Fida N, Barman P et al. Frailty Assessment in Advanced Heart Failure. J Card Fail 2016;22:840-844.

10. Mlynarska A, Mlynarski R, Biernat J, Sosnowski M, Golba KS. Frailty Syndrome in Heart Failure Patients who are Receiving Cardiac Resynchronization. Pacing Clin Electrophysiol 2016;39:370-374.

11. Mlynarska A, Mlynarski R, Marcisz C, Golba KS. Modified frailty as a novel factor in predicting the response to cardiac resynchronization in the elderly population. Clin Interv Aging 2019;14:437-443.

12. Singh M, Rihal CS, Lennon RJ, Spertus JA, Nair KS, Roger VL. Influence of frailty and health status on outcomes in patients with coronary disease undergoing percutaneous revascularization. Circ Cardiovasc Qual Outcomes 2011;4:496-502.

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08-10-2021

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Gómez Jiménez E, Avendaño Céspedes A, Cortés Zamora EB, García Molina R, Abizanda P. Prevalencia de fragilidad en adultos mayores hospitalizados. Revisión sistemática: e202110158. Rev Esp Salud Pública [Internet]. 8 de octubre de 2021 [citado 26 de mayo de 2025];95:34 páginas. Disponible en: https://ojs.sanidad.gob.es/index.php/resp/article/view/643

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