Evidence map›Paper›PMID 30261879›Full record

ArticleCardiovascular diabetology2018

Both pre-frailty and frailty increase healthcare utilization and adverse health outcomes in patients with type 2 diabetes mellitus.

Chia-Ter Chao, Jui Wang, Kuo-Liong Chien, COhort of GEriatric Nephrology in NTUH (COGENT) study group

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Cardiovascular diabetology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 76 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
76citing papers in PubMed, 4 pooled it
7.6field-weighted citation impact, top 2% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

76 citing papers in PubMed, 4 syntheses or guidelines pooled it, 131 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Trial
  6. Article
  7. Article
  8. Article
  9. Article
  10. Article
  11. Article
  12. Article
  13. Frailty Among Patients With ADPKD.Kidney international reports · 2025
    Article
  14. Review
  15. Article
  16. Article
  17. Article
  18. Observational
  19. Article
  20. Article

16 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 2 institutions in 1 country.

Chia-Ter ChaoDepartment of Medicine, National Taiwan University Hospital BeiHu Branch, Taipei, Taiwan.
Jui WangInstitute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, No. 1, Sec. 4, Roosevelt Road, Taipei, 10617, Taiwan.
Kuo-Liong ChienInstitute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, No. 1, Sec. 4, Roosevelt Road, Taipei, 10617, Taiwan. klchien@ntu.edu.tw.
COhort of GEriatric Nephrology in NTUH (COGENT) study group
National Taiwan University · TWNational Taiwan University Hospital · TW

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDiabetes mellitus (DM) correlates with accelerated aging and earlier appearance of geriatric phenotypes, including frailty. However, whether pre-frailty or frailty predicts greater healthcare utilization in diabetes patients is unclear.

methodsFrom the Longitudinal Cohort of Diabetes Patients in Taiwan (n = 840,000) between 2004 and 2010, we identified 560,795 patients with incident type 2 DM, categorized into patients without frailty, or with 1, 2 (pre-frail) and ≥ 3 frailty components, based on FRAIL scale (Fatigue, Resistance, Ambulation, Illness, and body weight Loss). We examined their long-term mortality, cardiovascular risk, all-cause hospitalization, and intensive care unit (ICU) admission.

resultsAmong all participants (56.4 ± 13.8 year-old, 46.1% female, and 84.8% community-dwelling), 77.8% (n = 436,521), 19.2% (n = 107,757), 2.7% (n = 15,101), and 0.3% (n = 1416) patients did not have or had 1, 2 (pre-frail), and ≥ 3 frailty components (frail), respectively, with Fatigue and Illness being the most common components. After 3.14 years of follow-up, 7.8% patients died, whereas 36.6% and 9.1% experienced hospitalization and ICU stay, respectively. Cox proportional hazard modeling discovered that patients with 1, 2 (pre-frail), and ≥ 3 frailty components (frail) had an increased risk of mortality (for 1, 2, and ≥ 3 components, hazard ratio [HR] 1.05, 1.13, and 1.25; 95% confidence interval [CI] 1.02-1.07, 1.08-1.17, and 1.15-1.36, respectively), cardiovascular events (HR 1.05, 1.15, and 1.13; 95% CI 1.02-1.07, 1.1-1.2, and 1.01-1.25, respectively), hospitalization (HR 1.06, 1.16, and 1.25; 95% CI 1.05-1.07, 1.14-1.19, and 1.18-1.33, respectively), and ICU admission (HR 1.05, 1.13, and 1.17; 95% CI 1.03-1.07, 1.08-1.14, and 1.06-1.28, respectively) compared to non-frail ones. Approximately 6-7% risk elevation in mortality and healthcare utilization was noted for every frailty component increase.

conclusionPre-frailty and frailty increased the risk of mortality and cardiovascular events, and entailed greater healthcare utilization in patients with type 2 DM.

Indexed as

Health ResourcesAdultAgedAged, 80 and overAge FactorsCardiovascular DiseasesDatabases, FactualDiabetes Mellitus, Type 2FemaleFrail ElderlyFrailtyGeriatric AssessmentHumansIncidenceIntensive Care UnitsLongitudinal StudiesDiabetes mellitusFrail phenotypeFrailtyHospitalizationMortality

Identifiers

PMID30261879
PMCPMC6158921
OpenAlexW2892396086

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.