Leme Daniel Eduardo da Cunha, Thomaz Raquel Prado, Borim Flávia Silvia Arbex, Brenelli Sigisfredo Luiz, Oliveira Daniel Vicentini de, Fattori André
Programa de Pós-Graduação em Gerontologia, Faculdade de Ciências Médicas, Universidade Estadual de Campinas. R. Tessália Vieira de Camargo 126, Cidade Universitária Zeferino Vaz. 13083-887 Campinas SP Brasil.
Cien Saude Colet. 2019 Jan;24(1):137-146. doi: 10.1590/1413-81232018241.04952017.
This study aims to analyze the impact of frailty, multimorbidity and disability on the survival of elderly people attended in a geriatric outpatient facility, and identify the clinical risk factors associated with death. It is a longitudinal study, with 133 elderly people initially evaluated in relation to frailty, multimorbidity (simultaneous presence of three or more chronic diseases) and disability in Daily Life Activities. The Kaplan Meier method was used to analyze survival time, and the Cox regression was used for association of the clinical factors with death. In follow-up over six years, 21.2% of the participants died, survival being lowest among those who were fragile (p < 0.05). The variables frailty (HR = 2.26; CI95%: 1.03-4.93) and Chronic Renal Insufficiency (HR = 3.00; CI95%: 1.20-7.47) were the factors of highest risk for death in the multivariate analysis. Frailty had a negative effect on the survival of these patients, but no statistically significant association was found in relation to multimorbidity or disability. Tracking of vulnerabilities in the outpatient geriatric service is important, due to the significant number of elderly people with geriatric syndromes that use this type of service, and the taking of decisions on directions for care of these individuals.
本研究旨在分析衰弱、多种疾病并存和残疾对老年门诊患者生存的影响，并确定与死亡相关的临床风险因素。这是一项纵向研究，对133名老年人进行了初步评估，涉及衰弱、多种疾病并存（同时存在三种或更多慢性疾病）以及日常生活活动中的残疾情况。采用Kaplan-Meier方法分析生存时间，Cox回归用于分析临床因素与死亡的相关性。在六年的随访中，21.2%的参与者死亡，衰弱者的生存率最低（p<0.05）。在多变量分析中，衰弱（HR=2.26；95%CI：1.03-4.93）和慢性肾功能不全（HR=3.00；95%CI：1.20-7.47）是死亡的最高风险因素。衰弱对这些患者的生存有负面影响，但未发现与多种疾病并存或残疾有统计学上的显著关联。由于大量患有老年综合征的老年人使用这种门诊服务，且需要对这些个体的护理方向做出决策，因此在老年门诊服务中追踪脆弱性很重要。
