Association Between Frailty and Mortality, Falls and Hospitalisation Among Patients Undergoing Dialysis: A Systematic Review and Meta-Analysis.
Wan-Qiao He, Xiao-Ming Zhang, Yi-Zhen Zhang and 3 others
PMID 39899271WHAT IT FOUND
Frailty was common in dialysis patients and was associated with higher mortality, falls and hospitalisation.
It supports frailty screening in dialysis care, but does not show screening improves outcomes.
Key findings
01Across 26 studies of 14,086 dialysis patients, frailty prevalence was 43%.
02Frailty was associated with higher mortality in dialysis patients (HR 2.18; 95% CI 1.76-2.70).
03Frailty was associated with higher falls risk (RR 1.63; 95% CI 1.45-1.85) and hospitalisation risk (RR 1.46; 95% CI 1.33-1.62).
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This is a review of observational studies, so it shows an association, not that frailty caused mortality, falls or hospitalisation. Frailty was measured with different tools, and the Clinical Frailty Scale subgroup did not show a significant mortality association. The included studies differed in dialysis type, follow-up length, country and adjusted risk factors. This made the pooled estimates uncertain. The authors converted some effect measures to make pooling possible, which may introduce methodological bias. The review reports prevalence and risk, but it does not test whether frailty screening or nurse-led interventions improve outcomes.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not read the higher mortality, falls and hospitalisation rates as proof that frailty caused them or that screening and treating frailty will reduce them. The evidence comes from observational studies, and the Clinical Frailty Scale subgroup did not show a significant mortality association.