Prevalence and risk factors of frailty in patients with chronic obstructive pulmonary disease: systematic review and meta-analysis

ObjectiveTo systematically review the prevalence and risk factors for frailty in patients with chronic obstructive pulmonary disease (COPD).MethodsA systematic review and meta-analysis were conducted, and a search of the PubMed, Embase and Web of Science databases was carried out to collect Chinese and English studies on frailty and COPD published up to September 5, 2022.ResultsA total of 38 articles were included for the quantitative analysis after the collected literature was either included or omitted based on pertinent criteria. The results indicated that the estimated overall pooled prevalence of frailty was 36% (95% confidence interval [CI] = 31-41%), and the estimated pre-frailty was 43% (95% CI = 37-49%). A higher age (odds ratio [OR] = 1.04; 95% CI = 1.01-1.06) and higher COPD assessment test (CAT) score (OR = 1.19; 95% CI = 1.12-1.27) were associated with a significantly increased likelihood of frailty in patients with COPD. However, a higher educational attainment (OR = 0.55; 95% CI = 0.43-0.69) and higher income (OR = 0.63; 95% CI = 0.45-0.88) were associated with a significantly reduced risk of frailty in patients with COPD. A total of 17 other risk factors for frailty were identified via qualitative synthesis.ConclusionThe incidence of frailty in patients with COPD is high, and there are many influencing factors. Key summary pointsAimThis study is the first to explore the risk factors of frailty in chronic obstructive pulmonary disease (COPD) patients.FindingsThe estimated prevalence of frailty in patients with COPD was 36%.MessageAge, education level, income level and CAT score are risk factors for frailty in COPD patients.