Marie Herr ; UMR 1168, UFR des Sciences de la Santé Simone Veil, 2 avenue de la source de la Bièvre, 78180 Montigny-le-Bretonneux, France ;
J Nutr Health Aging. 2019;23(5):466-473. doi: 10.1007/s12603-019-1186-x.
To assess the relationship between changes of frailty status and intervening hospitalizations, using information of the GAZEL cohort, matched with the data of the French National Health Data System.
Observational cohort study.
Community-dwelling adults of the GAZEL cohort (n = 12145; aged between 58 and 73 years in 2012).
Frailty was determined with the Strawbridge questionnaire in 2012, 2013 and 2014. Data regarding hospitalizations (notably their number, length of stay, emergency department use, and main diagnosis) were collected from the French National Health Data System. The relationship between intervening hospitalizations and changes of frailty status over time was assessed with multivariate Markov models.
The prevalence of frailty was 14% in 2012 and 2013 and 17% in 2014. A total of 2715 changes in frailty status were observed from 2012 to 2014. At least one hospitalization was recorded for 1453 people (12%) between the 2012 and 2013 questionnaires, and 1472 (13%) between the 2013 and 2014 questionnaires. No association was found between intervening hospitalizations and changes of frailty status (aHR 1.14 [0.97-1.35] for robust to frail transition and aHR 0.89 [0.73-1.08] for frail to robust transition). However, repeated hospitalizations, hospitalizations after emergency department use, surgery and several diagnosis groups were significantly associated with transitions towards frailty or its recovery.
Hospitalizations encompass a wide range of clinical situations, some of them being associated with incident frailty. An early recognition of these situations could help to better prevent and manage frailty in the early old age.
利用 GAZEL 队列的信息，并与法国国家健康数据系统的数据相匹配，评估虚弱状态变化与干预性住院之间的关系。
观察性队列研究。
GAZEL 队列的社区居住成年人（n=12145；2012 年年龄在 58 至 73 岁之间）。
2012 年、2013 年和 2014 年使用 Strawbridge 问卷确定虚弱程度。从法国国家健康数据系统收集有关住院（特别是住院次数、住院时间、急诊使用和主要诊断）的数据。使用多变量马尔可夫模型评估干预性住院与随时间变化的虚弱状态之间的关系。
2012 年和 2013 年的虚弱患病率为 14%，2014 年为 17%。2012 年至 2014 年共观察到 2715 例虚弱状态变化。在 2012 年至 2013 年问卷之间，有 1453 人（12%）记录了至少一次住院，在 2013 年至 2014 年问卷之间，有 1472 人（13%）记录了至少一次住院。干预性住院与虚弱状态变化之间没有关联（从稳健到虚弱的过渡的调整后危险比为 1.14[0.97-1.35]，从虚弱到稳健的过渡的调整后危险比为 0.89[0.73-1.08]）。然而，反复住院、急诊后住院、手术和几个诊断组与向虚弱或其恢复的过渡显著相关。
住院涵盖了广泛的临床情况，其中一些与虚弱的发生有关。早期识别这些情况有助于在老年早期更好地预防和管理虚弱。
