类风湿关节炎患者衰弱发生率的系统评价

Prevalence of frailty in patients with rheumatoid arthritis:a systematic review

目的系统评价类风湿关节炎(RA)患者衰弱发生率。方法系统检索有关RA患者衰弱发生率的观察性研究,严格按照循证医学研究方法进行文献筛选、资料提取及文献质量评价。应用Stata 16.0软件进行Meta分析、Egger线性回归分析。结果本研究共纳入26篇文献,总样本量22547例。结果显示,RA患者衰弱总体发生率为36%(95%CI:0.26~0.45,P<0.001),衰弱前期总体发生率为43%(95%CI:0.36~0.50,P<0.001)。亚组分析结果显示,女性、60岁及以上、住院、欧洲地区和基于多维度综合衰弱评估工具及特异性RA衰弱评估工具评估的RA患者衰弱发生率更高。结论RA患者衰弱及衰弱前期总体发生率均较高,且在不同年龄、性别、研究场所、区域及采用不同评估工具类型的患者中存在差异。

Objective To systematically evaluate the prevalence of frailty in patients with rheumatoid arthritis(RA).Methods A systematic search method for observational studies on the prevalence of frailty in patients with RA was conducted,and literature screening,data extraction as well as evaluation of literature quality were performed in strict accordance with evidence-based medical research methodology.Meta-analysis and Egger′s linear regression analysis were performed by Stata 16.0 software.Results Twenty-six literatures were included in the study,including a total sample size of 22,547 patients.The results of the analysis showed that the total prevalence of frailty in patients with RA was 36%(95%CI,0.26 to 0.45,P<0.001),and the prevalence of pre-frailty was 43%(95%CI,0.36 to 0.50,P<0.001).The results of subgroup analysis showed that the incidence of frailty was higher in RA patients with features of female,age over 60 years old,hospitalization,living in European region and evaluation with multi-dimensional comprehensive frailty assessment tool and the specific RA frailty assessment tool.Conclusion The overall incidence of frailty and pre-frailty in RA patients is high,and there are differences in the incidence of frailty among patients with different ages,genders,environments,regions,and types of assessment tools.