背景:虚弱已被确定为老年糖尿病患者不良结局的危险因素。本研究旨在通过系统评价和荟萃分析探讨虚弱对老年糖尿病患者预后的影响。目的是为临床决策提供见解。
方法:PubMed,WebofScience,Embase,从开始到9月10日,对Cochrane进行了系统的搜索,2023年。审稿人独立选择的研究,提取数据并评估研究质量。使用Stata15.1软件进行荟萃分析。这项研究的主要结果是死亡率,住院和残疾,次要结局是糖尿病并发症(包括肾病,微血管并发症,大血管病变,心血管事件,低血糖)和尿石症。
结果:本研究共纳入14项研究,具有低的偏倚风险和中等到良好的质量。结果表明,虚弱增加了死亡风险(HR1.91,95%CI1.55-2.35,P<0.001),住院(HR2.19,95%CI1.53-3.13,P<.001),老年糖尿病患者的残疾(HR3.84,95%CI2.35-6.28,P<.001)。此外,虚弱与糖尿病并发症(包括肾病,微血管并发症,大血管病变,心血管事件,低血糖),尿石症.
结论:虚弱是不良结局的重要预测因子,比如死亡率,住院治疗,以及老年糖尿病患者的残疾。准确评估老年糖尿病患者的衰弱可以帮助改善患者的不良结局。
BACKGROUND: Frailty has been identified as a risk factor for adverse outcomes in older adults with diabetes. This study aimed to investigate the impact of frailty on the prognosis of older adults with diabetes through a systematic review and meta-analysis, with the goal of offering insights for clinical decision-making.
METHODS: PubMed, Web of Science, Embase, Cochrane were systematically searched from inception to September 10th, 2023. Reviewers independently selected studies, extracted data and evaluated the quality of studies. Stata 15.1 Software was used to perform the meta-analysis. The primary outcomes of this study were mortality, hospitalization and disability, and the secondary outcomes were diabetes complications (including nephropathy, microvascular complications, macroangiopathy, cardiovascular events, hypoglycemia) and urolithiasis.
RESULTS: A total of 14 studies were included in this study, with low risk of bias and moderate to good quality. The results showed that frailty increased the risk of mortality (HR 1.91, 95% CI 1.55-2.35, P < .001), hospitalization (HR 2.19, 95% CI 1.53-3.13, P < .001), and disability in older adults with diabetes (HR 3.84, 95% CI 2.35-6.28, P < .001). In addition, frailty was associated with diabetes complications (including nephropathy, microvascular complications, macroangiopathy, cardiovascular events, hypoglycemia), urolithiasis.
CONCLUSIONS: Frailty is an important predictor of adverse outcomes, such as mortality, hospitalization, and disability in older adults with diabetes. Accurate assessment of the frailty in older adults with diabetes can help improve the adverse outcomes of patients.