UPRES EA 4638, University of Angers, UNAM, Angers, France.
Aging Clin Exp Res. 2013 Apr;25(1):107-9. doi: 10.1007/s40520-013-0010-4. Epub 2013 Mar 27.
Finding a biomarker of long length-of-stay (LOS) would provide a simple solution to target frail older inpatients at such risk. The aim of this study was to determine whether serum 25-hydroxyvitamin D (25OHD) deficiency, defined as serum concentration <25 nmol/L, was associated with long LOS among inpatients admitted to a geriatric acute care unit. Three hundred and six older inpatients (mean age 84.6 ± 6.4 years, 61.8% women) were consecutively included in this longitudinal prospective cohort study. Patients were separated into two groups according to LOS tertiles: highest tertile (≥14 days; n = 120) versus the other two tertiles combined (<14 days; n = 186). Serum 25OHD deficiency (58.3 vs. 38.7%, P = 0.001) and the prevalence of male gender (58.3 vs. 28.5%, P < 0.001) were higher among inpatients with the highest LOS compared with those with lower LOS. Serum 25OHD deficiency [odds ratio (OR) = 2.22, P = 0.001 for unadjusted model; OR = 1.87, P = 0.012 for fully adjusted model) and male gender (OR = 2.87, P < 0.001 for unadjusted model; OR = 2.64, P = 0.001 for full model) were associated with a high LOS. Vitamin D deficiency and male gender were risk factors for a long LOS in this pilot study. Using these risk factors to identify inpatients at risk of long LOS may be helpful in adapting early care plans, and thus improving inpatients' health and shortening LOS.
寻找一个长住院时间(LOS)的生物标志物将为针对这种风险的脆弱老年住院患者提供一个简单的解决方案。本研究的目的是确定血清 25-羟维生素 D(25OHD)缺乏症(定义为血清浓度<25nmol/L)是否与老年急性护理病房住院患者的长 LOS 相关。这项纵向前瞻性队列研究连续纳入了 306 名老年住院患者(平均年龄 84.6±6.4 岁,61.8%为女性)。根据 LOS 三分位值将患者分为两组:最高三分位组(≥14 天;n=120)与其他两个三分位值组合(<14 天;n=186)。与 LOS 较低的患者相比,最高 LOS 患者的血清 25OHD 缺乏症(58.3% vs. 38.7%,P=0.001)和男性比例(58.3% vs. 28.5%,P<0.001)更高。血清 25OHD 缺乏症[未调整模型的比值比(OR)=2.22,P=0.001;完全调整模型的 OR=1.87,P=0.012]和男性(未调整模型的 OR=2.87,P<0.001;完全调整模型的 OR=2.64,P=0.001)与 LOS 延长相关。在这项初步研究中,维生素 D 缺乏症和男性是 LOS 延长的危险因素。使用这些危险因素来识别 LOS 延长风险较高的住院患者,可能有助于制定早期护理计划,从而改善住院患者的健康状况并缩短 LOS。