Prognostic performance of clinical assessment tools following hip fracture in patients with chronic kidney disease

Wu, Henry H. L.; Mierlo, R. Van; McLauchlan, G.; Challen, Kirsty; Mitra, Sandip; Dhaygude, Ajay; Nixon, Andrew

doi:10.1007/s11255-021-02798-7

Cited by 6 publications

(5 citation statements)

References 52 publications

(37 reference statements)

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“…Almost in all of the studies, a physician assessed the CFS score (82.14%), in six cases it was assessed by a nurse (10.71%), in two cases alternatively by a physician or a nurse (3.57%), in one case by an occupational therapist (1.97%), and in one study the patients performed a CFS self-assessment (1.97%). In 10 studies (17.86%), in addition to the CFS, other frailty indexes were employed: the Fried frailty criteria ( 53 , 55 , 58 , 62 ), Sarcopenia ( 44 , 45 ), Frailty index ( 51 , 53 ), CKD Frailty Index Lab ( 67 ), Liver frailty index ( 55 ), PARTNER frailty scale ( 53 ), Derby frailty scale ( 51 , 52 ), and Acute frailty ( 51 , 52 ).…”

Section: Resultsmentioning

confidence: 99%

The Clinical Frailty Scale (CFS) employment in the frailty assessment of patients suffering from Non-Communicable Diseases (NCDs): A systematic review

et al. 2022

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BackgroundThe Clinical Frailty Scale (CFS) is a well-established tool that has been widely employed to assess patients' frailty status and to predict clinical outcomes in the acute phase of a disease, but more information is needed to define the implications that this tool have when dealing with Non-Communicable Diseases (NCDs).MethodsAn electronic literature search was performed on PubMed, Scopus, EMBASE, Web of Science, and EBSCO databases to identify studies employing the CFS to assess frailty in patients with NCDs.FindingsAfter database searching, article suitability evaluation, and studies' quality assessment, 43 studies were included in the systematic review. Researches were conducted mostly in Japan (37.5%), and half of the studies were focused on cardiovascular diseases (46.42%), followed by cancer (25.00%), and diabetes (10.71%). Simplicity (39.29%), efficacy (37.5%), and rapidity (16.07%) were the CFS characteristics mostly appreciated by the authors of the studies. The CFS-related results indicated that its scores were associated with patients' clinical outcomes (33.92%), with the presence of the disease (12.5%) and, with clinical decision making (10.71%). Furthermore, CFS resulted as a predictor of life expectancy in 23 studies (41.07%), clinical outcomes in 12 studies (21.43%), and hospital admissions/readmissions in 6 studies (10.71%).DiscussionCFS was found to be a well-established and useful tool to assess frailty in NCDs, too. It resulted to be related to the most important disease-related clinical characteristics and, thus, it should be always considered as an important step in the multidisciplinary evaluation of frail and chronic patients.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/display_record.asp? PROSPERO 2021, ID: CRD42021224214.

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Section: Resultsmentioning

confidence: 99%

The Clinical Frailty Scale (CFS) employment in the frailty assessment of patients suffering from Non-Communicable Diseases (NCDs): A systematic review

et al. 2022

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“…Overall, the studies were published from 1994 to 2022. Eleven studies were conducted in European countries [25][26][27][28][29][30][31][32][33][34][35], whereas the other studies were from the USA [14,[36][37][38][39], Japan [40][41][42], Taiwan [16,17], Canada [43], South Korea [44], and Turkey [45]. Additionally, 17 studies [13,14,16,17,[25][26][27][29][30][31]33,[35][36][37]40,44,46] were conducted in multicenter settings, and the number of participants considerably varied from 12 to 610,524.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…The longest follow-up duration was five years, and the participants' mean age ranged from 39 to 82.3 years. Out of the 26 studies, 20 investigated the prognosis of patients with hip fractures [14,16,17,[27][28][29]31,32,[34][35][36][37][38][39][40][41][43][44][45][46], and two [30,42] examined the prognosis of patients with spine fractures, whereas four [25][26][27]37] assessed the prognosis of both hip and spine fractures. Nine studies reported the surgery status for hip or spine fracture [17,28,31,32,37,38,40,43,44].…”

Section: Study Characteristicsmentioning

confidence: 99%

“…The risk-of-bias assessment using the JBI Prevalence Critical Appraisal Tool indicated that 15 studies [13,14,16,17,[25][26][27]30,33,35,36,38,40,42,44], six studies [31,32,34,38,41,46], and five studies [28,29,39,43,45] had a low, moderate, and high risk of bias, respectively (Table 2). A funnel plot asymmetry test was not performed for all outcomes included in the meta-analysis because of the small number of studies included.…”

Section: Risk Of Bias and Certainty Of Evidencementioning

confidence: 99%

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Mortality After Hip and Spine Fractures in Patients With End-Stage Kidney Disease: A Systematic Review and Meta-Analysis

Shimamura,

Kuniyoshi,

Ueta

et al. 2023

Cureus

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Fractures represent a major cause of disability in the elderly, and patients with fractures exhibit a higher mortality rate than those without. Fractures are also an important health problem among patients with endstage kidney disease (ESKD) requiring hemodialysis, peritoneal dialysis, or kidney transplantation. To the best of our knowledge, no study in the literature has yet quantitatively summarized the mortality rates, and a summary of evidence on post-hip and spine fracture mortality in patients with ESKD is lacking.The purpose of this study is to quantitatively evaluate the mortality rate, one-year mortality rate, and fiveyear mortality rate after hip and spine fractures in patients with ESKD receiving kidney replacement therapy.The MEDLINE, Cochrane Central Register of Controlled Trials (CENTRAL), Embase, and ClinicalTrials.gov databases were comprehensively searched for reports on mortality rate and time-period mortality in patients with ESKD after hip or spine fractures up to June 2022. Prospective and retrospective cohort studies, as well as case series involving four or more patients, were included. Pooled mortality rate, one-year rate, and five-year mortality rate with 95% confidence intervals (CIs) were examined using a random-effects model. The risk of bias was assessed using the Joanna Briggs Institute (JBI) Prevalence Critical Appraisal Tool. Additionally, heterogeneity between studies was evaluated.A total of 26 studies were included in this meta-analysis. The one-year and five-year mortality rates after hip and spine fractures were 215.35-774.0 per 1,000 person-year and 148-194.1 per 1,000 person-year, respectively. After hip fractures, the one-year mortality rate was 27% (95% CI: 18-38%, I 2 = 98%), whereas the five-year mortality rate was 56% (95% CI: 41-71%, I 2 = 99%). After spine fractures, the one-year mortality rate was 10% (95% CI: 4-17%, I 2 = 70%), whereas the five-year mortality rate was 48.3%.The post-fracture mortality rate was high in patients with ESKD, particularly within one year after the occurrence of fractures. Additionally, the five-year mortality rate after hip femoral or spine fractures was high at approximately 50%.

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“…Multiple frailty screening tools have been evaluated in CKD populations and perform reasonably well [28][29][30][31][32]. Notably, the widely cited Clinical Frailty Scale (CFS) [21,33], a global 9-point scale that guides the clinical judgement of an individual's frailty status, has been shown to be associated with adverse outcomes in Australian, Canadian, Japanese, South Korean, and UK CKD populations [34][35][36][37][38][39][40][41][42][43][44]. A limitation of the CFS is that it relies on a healthcare professional to make a subjective assessment, albeit an informed one.…”

Section: Frailty Identification and Assessmentmentioning

confidence: 99%

Targeted Non-Pharmacological Interventions for People Living with Frailty and Chronic Kidney Disease

Mayes

Young

Blacklock

et al. 2022

Kidney and Dialysis

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Frailty is highly prevalent within people living with chronic kidney disease (CKD) and is associated with the increased risk of falls, hospitalisation, and mortality. Alongside this, individuals with CKD report a high incidence of depression and reduced quality of life. The identification of frailty within nephrology clinics is needed to establish comprehensive management plans to improve clinical outcomes and quality of life for people with CKD. Current research exploring the role of non-pharmacological management has primarily focussed on exercise and physical activity interventions in the frail CKD population. However, there is a growing evidence base and interest in this area. This review provides an up-to-date overview of the literature into frailty assessment in CKD and subsequent non-pharmacological treatment approaches.

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Prognostic performance of clinical assessment tools following hip fracture in patients with chronic kidney disease

Cited by 6 publications

References 52 publications

The Clinical Frailty Scale (CFS) employment in the frailty assessment of patients suffering from Non-Communicable Diseases (NCDs): A systematic review

The Clinical Frailty Scale (CFS) employment in the frailty assessment of patients suffering from Non-Communicable Diseases (NCDs): A systematic review

Mortality After Hip and Spine Fractures in Patients With End-Stage Kidney Disease: A Systematic Review and Meta-Analysis

Targeted Non-Pharmacological Interventions for People Living with Frailty and Chronic Kidney Disease

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