Systematic Reviews
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jan 6, 2024; 12(1): 107-118
Published online Jan 6, 2024. doi: 10.12998/wjcc.v12.i1.107
Impact of frailty on outcomes of elderly patients undergoing percutaneous coronary intervention: A systematic review and meta-analysis
Shi-Shi Wang, Wang-Hao Liu
Shi-Shi Wang, Department of Emergency Medicine, Huzhou Third Municipal Hospital, The Affiliated Hospital of Huzhou University, Huzhou 313000, Zhejiang Province, China
Wang-Hao Liu, Department of Geriatrics, Huzhou Third Municipal Hospital, the Affiliated Hospital of Huzhou University, Huzhou 313000, Zhejiang Province, China
Author contributions: Wang SS and Liu WH designed the research; Wang SS and Liu WH performed the research; Wang SS analyzed the data; Wang SS and Liu WH wrote the paper.
Conflict-of-interest statement: The authors declare that they have no conflict of interest to disclose.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Wang-Hao Liu, MD, Professor, Research Scientist, Department of Geriatrics, Huzhou Third Municipal Hospital, the Affiliated Hospital of Huzhou University, No. 2088 Tiaoxi East Road, Wuxing District, Huzhou 313000, Zhejiang Province, China.
Received: October 27, 2023
Peer-review started: October 27, 2023
First decision: November 21, 2023
Revised: November 30, 2023
Accepted: December 15, 2023
Article in press: December 15, 2023
Published online: January 6, 2024
Research background

In exploring the intricate relationship between frailty and outcomes in elderly patients undergoing percutaneous coronary intervention (PCI), this study addressed existing gaps in understanding. The relevance of this issue is emphasized given the increasing prevalence of frailty in the aging population.

Research motivation

The motivation behind this research lies in recognizing the clinical significance of frailty in elderly PCI patients and its potential influence on short-term and long-term outcomes. The study aimed to inform clinical practices and enhance patient care by comprehensively exploring the impact of frailty.

Research objectives

The research objectives encompassed a thorough assessment of the association between frailty and key outcomes, including in-hospital mortality, all-cause mortality, major adverse cardiovascular events, and major bleeding. The investigation also sought to identify potential outcome variations based on different study designs, patient characteristics, and indications for PCI. Furthermore, it explored the implications of frailty assessment on personalized care plans and its integration into routine clinical practice.

Research methods

Comprehensive search strategies were applied across the PubMed/MEDLINE, EMBASE, Cochrane Library, and Web of Science databases. Statistical methods, including risk ratios and hazard ratios, ensured a robust and standardized approach. Subgroup analyses were conducted to explore variations in outcomes across different study characteristics.

Research results

The results of the study established a compelling association between frailty and adverse outcomes in elderly PCI patients. Specific risk increments, such as a three-fold higher risk of in-hospital mortality and a two-fold increase in all-cause mortality, underscored the comprehensive impact of frailty on cardiovascular health. The findings were consistent across retrospective and prospective study designs, affirming the robustness of the association.

Research conclusions

In conclusion, the study emphasizes the clinical significance of frailty assessment in the pre-PCI evaluation of elderly patients. It underscores the need for tailored care plans, acknowledging frailty as a potent predictor of adverse events. The research contributes to the existing knowledge by synthesizing key findings and provides a foundation for future research endeavors.

Research perspectives

Future research is encouraged to explore interventions targeting frailty and their potential to improve outcomes in elderly PCI patients, advocating for standardized frailty assessment tools and multidisciplinary approaches to enhance the holistic care of this vulnerable patient population.