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Review article
Available online 13 July 2026

Impact of frailty on hospital and intensive care unit readmission among critically ill patients: A systematic review and meta-analysis

Impacto de la fragilidad en la readmisión hospitalaria y en la unidad de cuidados intensivos entre pacientes críticamente enfermos: una revisión sistemática y metanálisis
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Sulekha Saxenaa,
Corresponding author
dr.sulekha2008@rediffmail.com

Corresponding author.
, Sanjay Singhalb, Mohan Gurjarc, Kuljit Kumard, Shiv Kumar Mudgale
a Critical Care Medicine, King George’s Medical University, Lucknow, India
b Respiratory Medicine, TS Mishra Medical College, Lucknow, India
c Critical Care Medicine, Sanjay Gandhi Post Graduate Institute of Medical Sciences (SGPGIMS), Lucknow, India
d Orthopaedics, Kalpana Chawla Government Medical College, Karnal, Haryana, India
e College of Nursing, All India Institute of Medical Sciences-Deoghar, India
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Abstract

Frailty is increasingly recognized as an important predictor of adverse outcomes in critically ill patients, but its association with hospital and Intensive Care Unit (ICU) readmissions remains uncertain. We conducted a systematic review and meta-analysis of observational studies in accordance with PRISMA and MOOSE guidelines (PROSPERO: CRD420251046386). PubMed, EMBASE, and Scopus were searched from inception to May 6, 2025. Eleven studies involving 1,051,568 patients were included. Frailty was associated with a significantly increased risk of hospital readmission (pooled RR 1.66, 95% CI 1.16–2.37; I² = 99.2%; 7 studies). In contrast, no significant association was observed between frailty and ICU readmission (pooled RR 1.55, 95% CI 0.93–2.58; I² = 89.3%; 5 studies). Subgroup analyses suggested that heterogeneity was partly explained by differences in frailty assessment methods, study design, and patient populations. Frailty appears to be an important predictor of hospital readmission in critically ill patients, whereas its association with ICU readmission remains uncertain and warrants further investigation.

Keywords:
Frailty
Readmission
Critically ill patients
Resumen

La fragilidad es reconocida cada vez más como un importante predictor de resultados adversos en pacientes críticamente enfermos; sin embargo, su asociación con las readmisiones hospitalarias y en la unidad de cuidados intensivos (UCI) sigue siendo incierta. Realizamos una revisión sistemática y un metanálisis de estudios observacionales de acuerdo con las directrices PRISMA y MOOSE (PROSPERO: CRD420251046386). Se realizaron búsquedas en PubMed, EMBASE y Scopus desde su inicio hasta el 6 de mayo de 2025. Se incluyeron once estudios que involucraron a 1.051.568 pacientes. La fragilidad se asoció con un riesgo significativamente mayor de readmisión hospitalaria (RR combinada 1,66; IC del 95%: 1,16–2,37; I² = 99,2%; 7 estudios). En contraste, no se observó una asociación significativa entre la fragilidad y la readmisión en la UCI (RR combinada 1,55; IC del 95%: 0,93–2,58; I² = 89,3%; 5 estudios). Los análisis por subgrupos sugirieron que la heterogeneidad se explicaba parcialmente por diferencias en los métodos de evaluación de la fragilidad, el diseño de los estudios y las poblaciones de pacientes. La fragilidad parece ser un predictor importante de readmisión hospitalaria en pacientes críticamente enfermos, mientras que su asociación con la readmisión en la UCI sigue siendo incierta y requiere investigación adicional.

Palabras clave:
Fragilidad
Readmisión
Pacientes críticamente enfermos

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