Title:Systematic Review of the Association of the Hospital Frailty Risk Score
with Mortality in Patients with Cerebrovascular and Cardiovascular
Disease
Volume: 20
Issue: 3
Author(s): Balamrit Singh Sokhal, Sowmya Prasanna Kumar Menon, Charles Willes, Nadia Corp, Andrija Matetić, Christian Mallen and Mamas Mamas*
Affiliation:
- Keele Cardiovascular
Research Group, Centre for Prognosis Research, Keele University, Keele, Staffordshire, ST5 5BG, United Kingdom
Keywords:
Frailty, cardiovascular disease, systematic review, hospital frailty risk score, mortality, cerebrovascular disease, atrial fibrillation.
Abstract:
Background: There is limited systematic data on the association between the Hospital
Frailty Risk Score (HFRS) and characteristics and mortality in patients with cerebrovascular and cardiovascular
disease (CVD). This systematic review aimed to summarise the use of the HFRS in describing
the prevalence of frailty in patients with CVD, the clinical characteristics of patients with
CVD, and the association between frailty on the likelihood of mortality in patients with CVD.
Methods: A systematic literature search for observational studies using terms related to CVD,
cerebrovascular disease, and the HFRS was conducted using 6 databases in accordance with the
Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies were
appraised using the Newcastle-Ottawa Scale (NOS).
Results: Seventeen observational studies were included, all rated ‘good’ quality according to the
NOS. One study investigated 5 different CVD cohorts (atrial fibrillation (AF), heart failure (HF),
hypotension, hypertension, and chronic ischemic heart disease), 1 study investigated 2 different
CVD cohorts (AF and acute myocardial infarction (AMI)), 6 studies investigated HF, 3 studies
investigated AMI, 4 studies investigated stroke, 1 study investigated AF, and 1 study investigated
cardiac arrest. Increasing frailty risk category was associated with increased age, female sex,
and non-white racial group across all CVD. Increasing frailty risk category is also associated
with increased length of hospital stay, total costs, and increased odds of 30-day all-cause mortality
across all CVD.
Conclusions: The HFRS is an efficient and effective tool for stratifying frailty in patients with
CVD and predicting adverse health outcomes.