Abstract:

Objective To systematically evaluate the effects of frailty on adverse health outcomes in patients with chronic obstructive pulmonary disease（COPD）. Methods Several electronic databases（Pubmed,Web of Science,Wiley Online Library,Cochrane Library,EBSCO host,CINAHL,Springer Link,Scopus,CNKI,WanFang data,CBM and VIP） were searched from inception to August 2019,in order to collect relevant English or Chinese studies examining the association between frailty and at least one health outcome of COPD patients. The quality appraisal was conducted using NOS scale or AHRQ scale according to research type. Results A total of 12 studies involving 4 196 patients were adopted,including 7 cohort studies and 5 cross-sectional studies. Descriptive analysis of the systematic review was conducted according to the Integral Conceptual Model of Frailty proposed by Gobbens et al. Results shows that frailty is significantly associated with an increased risk of disability,decreased quality of life,increasedutilization of healthcare resources and increased risk of death. Conclusion Based on the systematic review,frailty is closely associated with a variety of adverse health outcomes in COPD patients. Therefore,domestic scholars should pay more attention to frailty. Early assessment,early identification and early intervention in frailty can help to prevent or delay the progression of frailty,which is of great significance to improve the health outcomes of COPD patients.

Key words: Frailty, Chronic Obstructive Pulmonary Disease, Health Outcomes, Systematic Review, Nursing Care

摘要：

目的 系统评价衰弱对COPD患者不良健康结局的影响。方法 计算机检索PubMed、Web of Science、Wiley Online Library、Cochrane Library、EBSCO、CINAHL、Springer Link、Scopus、中国期刊全文数据库、万方数据库、中国生物医学文献数据库和中国科技期刊全文数据库,检索时限为建库至2019年8月,收集关于衰弱与COPD患者不良健康结局的队列研究、病例对照研究和横断面研究。根据研究类型选择纽尔卡斯渥太华量表或美国卫生保健质量和研究机构推荐的横断面研究质量评价标准进行质量评价。视纳入研究情况进行Meta合并或描述性分析。 结果 纳入12项研究,包括7项队列研究和5项横断面研究,总样本量4 196例。基于整合衰弱模式对健康结局进行分类,描述性分析结果显示,衰弱可导致COPD患者失能风险升高,失能程度加重,生活质量下降,医疗资源使用增加和死亡风险升高。结论 衰弱与COPD患者多种不良健康结局密切相关,国内学者应提高对衰弱的关注度,早评估、早识别、早干预衰弱,有利于预防或延缓衰弱的进程,改善COPD患者的健康结局。

关键词: 衰弱, 慢性阻塞性肺疾病, 健康结局, 系统评价, 护理