Association Between Frailty and Mortality, Falls and Hospitalisation Among Patients Undergoing Dialysis: A Systematic Review and Meta-Analysis.

Aim: Frailty is a risk factor for adverse events in older individuals; however, it has not been fully verified in patients undergoing dialysis. Our aim was to verify the association between frailty and adverse outcomes consisting of mortality, falls and hospitalisation among patients undergoing dialysis by a systematic review and meta-analysis.

Design: Systematic review and meta-analysis.

Methods: Multiple internet databases, were searched from the establishment of each database to April 2022, including the PubMed, EMbase, Cochrane, CNKI, WanFang and China Science and Technology Journal (VIP) databases. Cohort studies exploring the association between frailty and adverse outcomes among patients undergoing dialysis were analysed. The Newcastle Ottawa Scale (NOS) was used to assess the risk of bias in the included studies. A random effects model was used to pool the effect size, and comprehensive analyses consisting of subgroup analysis, sensitivity analysis and publication bias were assessed.

Results: The search initially identified 2744 studies from six databases. After the screening, 26 studies including 14,089 patients with dialysis aged 44.95-78.10 years were included in the final analysis, all of which were observational cohort studies. The pooled results showed that frailty was a powerful predictor of adverse outcomes (mortality, falls and hospitalisation) among the patients. Therefore, dialysis patients should be screened for early frailty and appropriate interventions should be implemented to improve adverse outcomes.