Department of Physiotherapy, Addenbrooke's Hospital, Cambridge, United Kingdom.
Department of Physiotherapy, Luton and Dunstable Hospital, Luton, United Kingdom.
Geriatr Gerontol Int. 2017 Jul;17(7):1063-1068. doi: 10.1111/ggi.12827. Epub 2016 Jul 18.
Frailty predicts inpatient mortality and length of stay, but its link to functional trajectories is under-researched. Addenbrooke's Hospital, Cambridge, UK, collects the Clinical Frailty Scale (CFS) within 72 h of admission for those aged ≥75 years. We studied whether the CFS links to functional trajectories in hospitalized older adults.
This was a retrospective observational study in an English university hospital. We analyzed all first episodes of county residents aged ≥75 years admitted to the Department of Medicine for the Elderly wards between December 2014 and May 2015. Data were extracted from the hospital's information systems. Patients were classified as non-frail (CFS 1-4), moderately frail (CFS 5-6) and severely frail (CFS 7-8). Function was retrospectively measured with the modified Rankin Scale (mRS) at preadmission, admission and discharge.
Of 539 eligible patients, 46 died during admission (mortality rates: 2% in CFS 1-4, 5% in CFS 5-6, 19% in CFS 7-8). Among the 493 survivors, 121 were non-frail, 235 moderately and 137 severely frail. The mean mRS of the non-frail was 1.8 (95% CI 1.7-2.0) at baseline, 3.3 (95% CI 3.1-3.5) on admission and 2.2 (95% CI 2.0-2.3) on discharge (mean length of stay 9 days). The moderately frail had a mean mRS of 2.9 (95% CI 2.8-3.0) at baseline, 4.0 (95% CI 3.8-4.1) on admission and 3.2 (95% CI 3.1-3.3) on discharge (mean length of stay 15 days). The severely frail had mean mRS of 3.5 (95% CI 3.3-3.6) at baseline, 4.3 (95% CI 4.1-4.4) on admission and 3.7 (95% CI 3.6-3.9) on discharge, respectively (mean length of stay 17 days).
In older inpatients, frailty might be linked to lower and slower functional recovery. Prospective work is required to confirm these trajectories and understand how to influence them. Geriatr Gerontol Int 2017; 17: 1063-1068.
虚弱预测住院患者的死亡率和住院时间，但它与功能轨迹的联系尚未得到充分研究。英国剑桥的阿登布鲁克医院在 75 岁以上患者入院后 72 小时内使用临床虚弱量表（CFS）进行评估。我们研究了 CFS 是否与住院老年患者的功能轨迹有关。
这是一项在英国大学医院进行的回顾性观察性研究。我们分析了 2014 年 12 月至 2015 年 5 月期间因年龄≥75 岁而入住老年医学科病房的所有县居民的首次入院情况。数据从医院的信息系统中提取。患者被分为非虚弱（CFS 1-4）、中度虚弱（CFS 5-6）和严重虚弱（CFS 7-8）。入院前、入院时和出院时采用改良 Rankin 量表（mRS）对功能进行回顾性测量。
在 539 名符合条件的患者中，46 人在住院期间死亡（死亡率：CFS 1-4 为 2%，CFS 5-6 为 5%，CFS 7-8 为 19%）。在 493 名幸存者中，121 人非虚弱，235 人中度虚弱，137 人严重虚弱。非虚弱者的基线 mRS 平均值为 1.8（95%CI 1.7-2.0），入院时为 3.3（95%CI 3.1-3.5），出院时为 2.2（95%CI 2.0-2.3）（平均住院时间为 9 天）。中度虚弱者的基线 mRS 平均值为 2.9（95%CI 2.8-3.0），入院时为 4.0（95%CI 3.8-4.1），出院时为 3.2（95%CI 3.1-3.3）（平均住院时间为 15 天）。严重虚弱者的基线 mRS 平均值为 3.5（95%CI 3.3-3.6），入院时为 4.3（95%CI 4.1-4.4），出院时为 3.7（95%CI 3.6-3.9）（平均住院时间为 17 天）。
在老年住院患者中，虚弱可能与较低和较慢的功能恢复有关。需要进行前瞻性研究来证实这些轨迹，并了解如何影响这些轨迹。老年医学杂志 2017；17:1063-1068.
