Frailty as a predictor of all-cause mortality in elderly patients undergoing percutaneous coronary intervention: A systematic review and meta-analysis

Abstract Background Frailty has been proposed as a poor prognostic indicator for elderly patients with coronary artery diseases (CAD). The objective of this meta-analysis was to evaluate the effects of frailty on all-cause mortality in elderly patients with CAD following percutaneous coronary intervention (PCI). Methods PubMed, Embase, the Cochrane library, Web of science, and ClinicalTrial.gov were searched for associated studies from their inception to April 30, 2021. Odds ratios (OR) were calculated to estimate the in-hospital and short-term outcomes, whereas the hazard ratios (HR) were pooled for long-term mortality using random-effects by Revman 5.3. Results A total of nine studies including 2658 elderly participants were included in this meta-analysis. It was identified that the prevalence of frailty ranged from 12.5 to 27.8%. Frailty was associated with increased in-hospital mortality (OR 3.59, 95% CI 2.01 - 6.42; I2 = 35%), short-term mortality (OR 6.61, 95% CI 2.89 - 15.16; I2 = 0%), as well as long-term mortality (HR 3.24, 95% CI 2.04- 5.14; I2 = 70%) in patients undergoing PCI. Besides, we also found that prefrailty was a predictor of all-cause mortality. Conclusions Frailty was associated with in-hospital, short-term and long-term mortality in elderly patients with PCI. The results may consolidate the importance of routine frailty screening in risk stratification in elderly patients with CAD who are considered for PCI.