Frailty As A Predictor of Mortality Among Elderly Patients With Pneumonia: A Systematic Review and Meta-Analysis

RA Tuty Kuswardhani¹, I Desak Putu Agung Krisdanti², Christina Permata Shalim³

¹Division  of  Geriatric  Medicine,  Department  of  Internal  Medicine,  Faculty  of  Medicine,  Udayana University/Prof Dr. I.G.N.G. Ngoerah Hospital, Bali, Indonesia

²Department of Pulmonology and Respiratory, Faculty of Medicine, Udayana University/Udayana University Hospital, Bali, Indonesia

³Siloam Hospitals Kebon Jeruk, Jakarta, Indonesia

ABSTRACT

Introduction: Pneumonia is a significant cause of morbidity and mortality among elderly patients.
Assessing the prognostic factors associated with pneumonia outcomes is crucial for clinical decision-making. This systematic review and meta-analysis aimed to evaluate the impact of frailty on mortality in elderly patients with pneumonia.
Methods: We performed a systematic search on the electronic databases PubMed, Cochrane Library, and Science Direct up to June 12th, 2023. Studies reporting the association between frailty and mortality in elderly patients with pneumonia were included. Quality assessment of the included studies was appraised using a Newcastle-Ottawa Scale. Pooled odds ratios (OR) with 95% confidence intervals (CI) were calculated using random-effects models.
Results: Seven studies involving a total of 376,170 elderly pneumonia patients were included in the meta-analysis. The pooled results demonstrated a significant association between frailty and mortality in this population (pooled OR = 2.76, 95% CI: 2.22-3.44; p<0.00001). Frailty was also significantly associated with prolonged hospitalization (pooled OR = 2.74, 95% CI: 1.90-3.96; p<0.00001).
Conclusion: Frailty is significantly associated with increased mortality and prolonged
hospitalization in elderly patients with pneumonia.
Keywords: elderly, frailty, mortality, pneumonia