Objective. Numerous studies have investigated the prognostic role of frailty in elderly patients with heart failure (HF), but the\nlimited size of the reported studies has resulted in continued uncertainty regarding its prognostic impact. The aim of this study\nwas to integrate the findings of all available studies and estimate the impact of frailty on the prognosis of HF by performing a\nsystematic review and meta-analysis. Methods. PubMed, Embase, Cochrane, and Web of Science databases were searched from\ninception to November 8th 2017 to identify eligible prospective studies. The Newcastle-Ottawa Scale (NOS) was used to evaluate\nstudy quality.The association between frailty and HF outcomes was reviewed. Overall hazard ratios (HRs) for the effects of frailty\non all-causemortality were pooled using a fixed-effect model and publication bias was evaluated using funnel plots. Results. A total\nof 10 studies involving 3033 elderly patients with HF were included in the systematic review and meta-analysis. All eligible studies\nindicated that frailty was of prognostic significance for HF patients.The HRs for the effects of frailty on all-cause mortality were\n1.70 (95% confidence interval (CI): 1.41â??2.04), based on the pooling of six studies that provided related data. However, publication\nbias was observed among the studies. Conclusions. Frailty has a high prevalence among older patients with HF. Elderly HF patients\nwith frailty have a poorer prognosis than those without frailty. Further studies are now required to implement the use of frailty\nassessment tools and explore effective interventions for frailty in older HF patients.
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