The Center of Gerontology and Geriatrics/National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China.
Key Laboratory of Biotherapy and Cancer Center/Collaborative Innovation Center for Biotherapy, West China Hospital, Sichuan University, Chengdu, China.
Sci Rep. 2019 Feb 4;9(1):1207. doi: 10.1038/s41598-018-38072-7.
Few studies have focused on frailty as a predictor of mortality and readmission among inpatients in the acute care setting, especially over long follow-up periods. We conducted this study to determine the impact of the frailty on subsequent mortality and readmission in this setting. This study was a prospective observational study conducted in the acute geriatric wards, with a three-year follow-up duration. We assessed frailty via the 36-item Frailty Index (FI), and a cut-off value of 0.25 was used to identify the presence or absence of frailty. We collected survival and readmission information through telephone interviews at 12, 24, and 36 months. We used the Cox regression model to examine the association between frailty and outcomes interested (death and readmission). The present study included 271 patients (mean age: 81.1 years old; 20.3% females), of whom 21.4% died during the 3-year follow-up period. One hundred and thirty-three patients (49.1%) were identified as being frail. The prevalence of frailty was similar in men and women (46.8% vs.58.2%, P = 0.130). Compared with non-frail patients, death and hospital readmission rates of frail patients were increased. Frailty was an independent predictor of 3-year death (adjusted hazard ratio (HR): 2.09; 95% confidence interval (CI): 1.20 to 3.63) and readmission (adjusted HR: 1.40; 95% CI: 1.04 to 1.88) after adjusting for several potential confounders. Frailty is prevalent among older inpatients and is a valuable predictor of 3-year mortality and hospital readmission in an acute care setting.
很少有研究关注衰弱作为急性护理环境中住院患者死亡率和再入院的预测因素,尤其是在长期随访期间。我们进行这项研究是为了确定衰弱对该环境中随后死亡率和再入院的影响。这项研究是一项前瞻性观察研究,在急性老年病房进行,随访时间为 3 年。我们通过 36 项衰弱指数(FI)评估衰弱情况,并使用 0.25 的截断值来确定是否存在衰弱。我们通过 12、24 和 36 个月的电话访谈收集生存和再入院信息。我们使用 Cox 回归模型来检查衰弱与感兴趣结局(死亡和再入院)之间的关联。本研究纳入了 271 名患者(平均年龄:81.1 岁;20.3%为女性),其中 3 年随访期间有 21.4%死亡。133 名患者(49.1%)被确定为衰弱。男性和女性的衰弱患病率相似(46.8%比 58.2%,P=0.130)。与非衰弱患者相比,衰弱患者的死亡和住院再入院率增加。衰弱是 3 年死亡(调整后的危险比(HR):2.09;95%置信区间(CI):1.20 至 3.63)和再入院(调整后的 HR:1.40;95% CI:1.04 至 1.88)的独立预测因素,调整了几个潜在的混杂因素。衰弱在老年住院患者中很常见,是急性护理环境中 3 年死亡率和医院再入院的有价值预测指标。