ReviewJournal of atrial fibrillation2018
What is the Impact of Frailty on Prescription of Anticoagulation in Elderly Patients with Atrial Fibrillation? A Systematic Review and Meta-Analysis.
Review in Journal of atrial fibrillation, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 48 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
48 citing papers in PubMed, 3 syntheses or guidelines pooled it, 86 citations in OpenAlex.
- A conceptual model of factors potentially influencing prescribing decisions for chronic conditions: an overview of systematic reviews.BMC medicine · 2025Pooled it
- Non-adherence to Thromboprophylaxis Guidelines in Atrial Fibrillation: A Narrative Review of the Extent of and Factors in Guideline Non-adherence.American journal of cardiovascular drugs : drugs, devices, and other interventions · 2021Pooled it
- Effectiveness and Safety of Oral Anticoagulants in Older Patients With Atrial Fibrillation: A Systematic Review and Meta-Analysis.Frontiers in pharmacology · 2020Pooled it
- Outcomes and Safety of Very-Low-Dose Edoxaban in Frail Patients With Atrial Fibrillation in the ELDERCARE-AF Randomized Clinical Trial.JAMA network open · 2022Trial
- Assessing Potential Benefit of Stroke Prophylaxis Therapy in Atrial Fibrillation and Atrial Flutter Using a Novel Competing Risk Scoring Tool.Journal of the American Heart Association · 2026Article
- Perioperative management of colorectal surgical patients receiving a direct oral anticoagulant: a scoping review, particular emphasis on procedure-specific risks, and pharmacogenomics.Frontiers in cardiovascular medicine · 2026Review
- Anticoagulation in Frail Older Adults with Non-Valvular Atrial Fibrillation: Clinical Challenges and Personalized Approach.Journal of clinical medicine · 2025Review
- Safety and effectiveness of anticoagulation therapy in older people with atrial fibrillation during exposed and unexposed treatment periods.Heart (British Cardiac Society) · 2025Article
- Influence of Ageing on the Pharmacodynamics and Pharmacokinetics of Chronically Administered Medicines in Geriatric Patients: A Review.Clinical pharmacokinetics · 2025Review
- Oral Anticoagulation Choice and Dosage in Very Elderly Patients with Atrial Fibrillation.Journal of cardiovascular development and disease · 2025Article
- Frailty and Cardiovascular Health.Journal of the American Heart Association · 2024Review
- Effect of nutritional status on adverse clinical events in elderly patients with nonvalvular atrial fibrillation: A retrospective cohort study.Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc · 2024Observational
- Assessment and Management of Atrial Fibrillation in Older Adults with Frailty.Geriatrics (Basel, Switzerland) · 2024Review
- Impact of Frailty on Healthcare Outcomes after Cardioembolic Ischaemic Stroke Due to Atrial Fibrillation.International journal of environmental research and public health · 2024Article
- Impact of frailty on the effectiveness and safety of non-vitamin K antagonist oral anticoagulants (NOACs) in patients with atrial fibrillation: a nationwide cohort study.European heart journal. Quality of care & clinical outcomes · 2024Article
- Frailty prevalence in older adults with atrial fibrillation: A cross-sectional study in a resource-limited setting.PloS one · 2024Article
- Associations of medicine use and ejection fraction with the coexistence of frailty and sarcopenia in a sample of heart failure outpatients: a cross-sectional study.BMC cardiovascular disorders · 2023Article
- The Use of Oral Anticoagulation Is Not Independently Associated with Mortality in Frail Older Patients with Repeated Falls.Journal of clinical medicine · 2023Article
- Initiation of oral anticoagulation in US older adults newly diagnosed with atrial fibrillation during hospitalization.Journal of the American Geriatrics Society · 2023Article
- Frailty and oral anticoagulant prescription in adults with atrial fibrillation: A systematic review.Aging medicine (Milton (N.S.W)) · 2023Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAtrial fibrillation (AF) and frailty are both associated with advanced age. Oral anticoagulants (OAC) effectively prevent strokes in AF patients but are underutilized in the elderly, possibly due to misperception of frailty.
objectiveWe performed a systematic review to determine the prevalence of frailty in patients with AF, and whether frailty was associated with reduced prescription of OAC.
methodsWe systematically searched Cochrane, MEDLINE, EMBASE, and PubMed databases. Search terms combined relevant words and MeSH headings: 1) atrial fibrillation, 2) frail elderly, and 3) geriatric assessments. Studies that measured frailty using a validated instrument, and involved OAC for AF in frail and non-frail patients were eligible for inclusion. Pooled odds ratios were calculated using random-effects model.
resultsOf 166 reviewed titles, only 3 studies (1204 patients) met the inclusion criteria. Two used the Reported Edmonton Frail Scale (total 509 patients), and one used the Canadian Study of Health and Aging Clinical Frailty Scale (682 patients). All 3 studies involved hospitalized patients with an average age of 85 ± 6 and 45% were male. The weighted mean prevalence of frailty in patients with atrial fibrillation was 39% (95%CI 36-42). The weighted mean rate of OAC use was 57±11%. Frailty was associated with non-prescription of OAC compared to non-frail (OR 0.49, 95% CI 0.32-0.74, I2 =45%).
conclusionThe prevalence of frailty in hospitalized elderly patients with AF is high, and the use of OAC is low in these patients. Frail elderly are significantly less likely to receive OAC.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.