Institute for Biomedicine of Ageing (IBA), Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), D-90408 Nürnberg, Germany,
Department of Internal Medicine III (Medicine of Ageing), Geriatrics Center Erlangen, Malteser Hospital Erlangen, D-91054 Erlangen, Germany,
Clin Interv Aging. 2019 Feb 25;14:473-484. doi: 10.2147/CIA.S191117. eCollection 2019.
We aimed to evaluate the abilities of a 21-item frailty index based on laboratory blood and urine tests (FI-Lab21) assessed at different points in time, ie, at admission to hospital (FI-Lab21) and before discharge from hospital (FI-Lab21), and the change of the FI-Lab21 during the hospital stay to predict 6-month and 1-year mortality in hospitalized geriatric patients.
Five hundred hospitalized geriatric patients aged ≥65 years were included in this analysis. Follow-up data were acquired after a period of 6 months and 1 year.
The FI-Lab21 and FI-Lab21 scores were 0.33±0.15 and 0.31±0.14, respectively (<0.001). The FI-Lab21 and FI-Lab21 both predicted 6-month and 1-year mortality (areas under the receiver operating characteristic curves: 0.72, 0.72, 0.77, and 0.75, respectively, all <0.001). The predictive abilities for 6-month and 1-year mortality of the FI-Lab21 were inferior compared with those of the FI-Lab21 (all <0.05). Patients with a reduction in or stable FI-Lab21 score during the hospital stay revealed lower 6-month and 1-year mortality rates compared with the persons whose FI-Lab21 score increased during the hospital stay (all <0.05). After adjustment for age, sex, and FI-Lab21, each 1% decrease in the FI-Lab21 during the hospital stay was associated with a decrease in 6-month and 1-year mortality of 5.9% and 5.3% (both <0.001), respectively.
The FI-Lab21 assessed at admission or discharge and the changes of the FI-Lab21 during the hospital stay emerged as interesting and feasible approaches to stratify mortality risk in hospitalized geriatric patients.
我们旨在评估基于实验室血液和尿液检查的 21 项衰弱指数（FI-Lab21）在不同时间点的能力，即在入院时（FI-Lab21）和出院前（FI-Lab21），以及住院期间 FI-Lab21 的变化，以预测住院老年患者的 6 个月和 1 年死亡率。
本分析纳入了 500 名年龄≥65 岁的住院老年患者。在经过一段时间的 6 个月和 1 年后获得了随访数据。
FI-Lab21 和 FI-Lab21 评分分别为 0.33±0.15 和 0.31±0.14（<0.001）。FI-Lab21 和 FI-Lab21 均预测 6 个月和 1 年死亡率（受试者工作特征曲线下面积：0.72、0.72、0.77 和 0.75，均<0.001）。FI-Lab21 预测 6 个月和 1 年死亡率的能力低于 FI-Lab21（均<0.05）。在住院期间 FI-Lab21 评分降低或稳定的患者的 6 个月和 1 年死亡率低于住院期间 FI-Lab21 评分增加的患者（均<0.05）。在校正年龄、性别和 FI-Lab21 后，住院期间 FI-Lab21 每降低 1%，6 个月和 1 年死亡率分别降低 5.9%和 5.3%（均<0.001）。
入院或出院时评估的 FI-Lab21 以及住院期间 FI-Lab21 的变化是一种有趣且可行的方法，可以对住院老年患者的死亡率风险进行分层。
