Graduate School of Medical Science and Engineering, Korea Advanced Institute of Science and Technology, Daejeon, Korea.
Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
J Am Geriatr Soc. 2018 Jan;66(1):157-160. doi: 10.1111/jgs.15204. Epub 2018 Jan 4.
Detecting frailty in older adults scheduled for surgery is important to predict the occurrence of adverse outcomes, but because of its complexity, frailty screening is not commonly performed. The objective of the current study was to assess whether frailty can be screened for using automatically measured usual gait speed (UGS) and mid-arm circumference (MAC) in the outpatient clinic.
Prospective, cross-sectional study.
Geriatric center of a tertiary hospital.
Outpatients aged 65 and older (N = 113).
Frailty status was evaluated according to a multidimensional frailty score (MFS) using a comprehensive geriatric assessment, and participants were classified into 5 categories. UGS was evaluated by having participants walk through the clinic using an automated laser-gated chronometer. MAC was recorded using a tape measure on a blood pressure cuff. Correlations between these two physical measurements and MFS were assessed.
The mean age of the 93 participants who successfully underwent UGS evaluation was 75.8 ± 4.7; 35 were male. In this population, the mean Charlson Comorbidity Index was 2.2 ± 1.4, mean MFS was 4.1 ± 2.0, and 20 participants were considered to be at high risk of experiencing adverse outcomes. Mean UGS was 0.75 ± 0.16 m/s, and mean MAC was 31.2 ± 1.9 cm); both physical parameters were correlated with MFS (UGS: standardized beta = -0.420, P < .001; MAC: standardized beta = -0.457, P < .001). Using UGS and MFS, the area under curve of receiver operating curve for determining which participants were at high risk of experiencing adverse outcomes was 0.809 (P < .001).
UGS and MAC are viable methods of clinically screening for frailty.
在接受手术的老年人中检测虚弱是预测不良结果发生的重要指标，但由于其复杂性，虚弱筛查并未广泛开展。本研究旨在评估在门诊中是否可以通过自动测量的日常步态速度（UGS）和上臂中部周长（MAC）来筛查虚弱。
前瞻性、横断面研究。
一家三级医院的老年医学中心。
年龄在 65 岁及以上的门诊患者（N=113）。
使用全面的老年评估多维虚弱评分（MFS）评估虚弱状态，并将参与者分为 5 类。UGS 通过让参与者在诊所使用自动激光门计时仪行走来评估。MAC 使用血压袖带上的卷尺记录。评估这两个身体测量值与 MFS 之间的相关性。
93 名成功接受 UGS 评估的参与者的平均年龄为 75.8±4.7 岁，其中 35 名为男性。在该人群中，平均 Charlson 合并症指数为 2.2±1.4，平均 MFS 为 4.1±2.0，有 20 名参与者被认为有发生不良结局的高风险。平均 UGS 为 0.75±0.16m/s，平均 MAC 为 31.2±1.9cm）；这两个身体参数均与 MFS 相关（UGS：标准化β=-0.420，P<0.001；MAC：标准化β=-0.457，P<0.001）。使用 UGS 和 MFS，确定哪些参与者有发生不良结局高风险的受试者工作特征曲线下面积为 0.809（P<0.001）。
UGS 和 MAC 是临床上筛查虚弱的可行方法。
