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功能状态对老年急性静脉血栓栓塞症患者 6 个月死亡率的影响:前瞻性队列研究的结果。

Impact of functional status on 6-month mortality in elderly patients with acute venous thromboembolism: results from a prospective cohort.

机构信息

Internal Medicine Department, Hospital Universitario 12 de Octubre, Avenida de Córdoba s/n, 28041, Madrid, Spain.

Pneumology Department, Hospital Universitario 12 de Octubre, Madrid, Spain.

出版信息

J Thromb Thrombolysis. 2018 Oct;46(3):325-331. doi: 10.1007/s11239-018-1685-3.

DOI:10.1007/s11239-018-1685-3
PMID:29873003
Abstract

Functional status linked to a poor outcome in a broad spectrum of medical disorders. Barthel Activities of Daily Life Index (BADLI) is one of the most extended tools to quantify functional dependence. Whether BADLI can help to predict outcomes in elderly patients with acute venous thromboembolism (VTE) is unknown. The current study aimed to ascertain the influence of BADLI on 6-month all-cause mortality in aged patients with VTE. This is a prospective observational study. We included consecutive patients older than 75-year-old with an acute VTE between April 2015 and April 2017. We analyzed several variables as mortality predictors, including BADLI-measured functional status. Afterward, we performed a multivariate analysis, using logistic regression, to identify all-cause mortality independent predictive factors. Two hundred and two subjects were included. Thirty-five (17%) patients died in the first 6 months. The leading cause of death was cancer (59%). After multivariable logistic regression, we identified BADLI and Charlson index as independent predictors for 6-months mortality [BADLI (every decrease of 10 points) OR 1.21 95% CI (1.03-1.42) and Charlson index OR 1.71 95% CI (1.21-2.43)]. Body mass index (BMI) values were inversely related to mortality [OR 0.85 95% CI (0.75-0.95)]. In conclusion, BADLI, BMI, and Charlson index scores are independent predictive factors for 6-month all-cause mortality in old patients with VTE.

摘要

日常生活活动能力与广泛的医学疾病不良预后相关。巴氏日常生活活动指数(BADLI)是量化功能依赖的最常用工具之一。BADLI 是否有助于预测老年急性静脉血栓栓塞症(VTE)患者的结局尚不清楚。本研究旨在确定 BADLI 对老年 VTE 患者 6 个月全因死亡率的影响。这是一项前瞻性观察性研究。我们纳入了 2015 年 4 月至 2017 年 4 月期间年龄在 75 岁以上的急性 VTE 连续患者。我们分析了包括 BADLI 测量的功能状态在内的几个变量作为死亡率预测因素。随后,我们使用逻辑回归进行多变量分析,以确定全因死亡率的独立预测因素。共纳入 202 例患者。35 例(17%)患者在 6 个月内死亡。死亡的主要原因是癌症(59%)。经过多变量逻辑回归分析,我们发现 BADLI 和 Charlson 指数是 6 个月死亡率的独立预测因素[BADLI(每降低 10 分)OR1.2195%CI(1.03-1.42)和 Charlson 指数 OR1.7195%CI(1.21-2.43)]。体质指数(BMI)值与死亡率呈反比[OR0.8595%CI(0.75-0.95)]。总之,BADLI、BMI 和 Charlson 指数评分是老年 VTE 患者 6 个月全因死亡率的独立预测因素。

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