1 School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
2 Department of Emergency Medicine, University of Alabama School of Medicine, Birmingham, AL, USA.
J Intensive Care Med. 2019 Apr;34(4):292-300. doi: 10.1177/0885066617715251. Epub 2017 Jul 5.
: Frailty is associated with increased morbidity and mortality in older persons. We sought to characterize the associations between the frailty syndrome and long-term risk of sepsis in a large cohort of community-dwelling adults.
: We analyzed data on 30 239 community-dwelling adult participants in the REasons for Geographic and Racial Differences in Stroke (REGARDS) cohort. We defined frailty as the presence of at least 2 frailty indicators (weakness, exhaustion, and low physical activity). We defined sepsis as hospitalization for a serious infection with ≥2 system inflammatory response syndrome criteria, identified for the period 2003-2012. We determined the associations between frailty and risk of first sepsis and sepsis 30-day case fatality.
: Among REGARDS participants, frailty was present in 6018 (19.9%). Over the 10-year observation period, there were 1529 first-sepsis hospitalizations. Frailty was associated with increased risk of sepsis (adjusted hazard ratio [HR] 1.44; 95% CI: 1.26 to 1.64). The total number of frailty indicators was associated with increased risk of sepsis ( P trend <.001). Among first-sepsis hospitalizations, frailty was associated with increased sepsis 30-day case fatality (adjusted OR 1.62; 95% CI: 1.06 to 2.50).
: In the REGARDS cohort, frailty was associated with increased long-term risk of sepsis and sepsis 30-day case fatality.
衰弱与老年人发病率和死亡率的增加有关。我们试图在一个大型社区居住成年人队列中描述衰弱综合征与脓毒症长期风险之间的关系。
我们分析了 REasons for Geographic and Racial Differences in Stroke（REGARDS）队列中 30239 名社区居住成年参与者的数据。我们将衰弱定义为存在至少 2 个衰弱指标（虚弱、疲惫和低身体活动）。我们将脓毒症定义为因严重感染住院，符合≥2 个全身炎症反应综合征标准，并在 2003-2012 年期间确定。我们确定了衰弱与首次脓毒症和脓毒症 30 天病死率风险之间的关系。
在 REGARDS 参与者中，有 6018 人（19.9%）存在衰弱。在 10 年观察期内，有 1529 例首次脓毒症住院。衰弱与脓毒症风险增加相关（调整后的危险比[HR] 1.44；95%CI：1.26 至 1.64）。衰弱指标的总数与脓毒症风险增加相关（P趋势<.001）。在首次脓毒症住院患者中，衰弱与脓毒症 30 天病死率增加相关（调整后的 OR 1.62；95%CI：1.06 至 2.50）。
在 REGARDS 队列中，衰弱与长期脓毒症风险和脓毒症 30 天病死率增加有关。
