Emergency Department, Caboolture Hospital, Queensland Health, McKean St, Caboolture, Queensland, Australia.
Projects and Service Partnerships, Caboolture Hospital, Queensland Health, McKean St, Caboolture, Queensland, Australia.
QJM. 2019 Dec 1;112(12):907-913. doi: 10.1093/qjmed/hcz203.
Clinical frailty scales (CFS) predict hospital-related outcomes. Frailty is more common in areas of higher socioeconomic disadvantage, but no studies exclusively report on the impact of CFS on hospital-related outcomes in areas of known socioeconomic disadvantage.
To evaluate the association of the CFS with hospital-related outcomes.
Retrospective observational study in a community hospital within a disadvantaged area in Australia (Social Economic Index for Areas = 0.1%).
The CFS was used in the emergency department (ED) for people aged ≥ 75 years. Frailty was defined as a score of ≥4. Associations between the CFS and mortality, admission rates, ED presentations and length of stay (LOS) were analysed using regression analyses.
Between 11 July 2017 and 31 March 2018, there were 5151 ED presentations involving 3258 patients aged ≥ 75 years. Frail persons were significantly more likely to be older, represent to the ED and have delirium compared with non-frail persons. CFS was independently associated with 28-day mortality, with odds of mortality increasing by 1.5 times per unit increase in CFS (95% CI: 1.3-1.7). Frail persons with CFS 4-6 were more likely to be admitted (OR: 1.2; 95% CI: 1.0-1.5), have higher geometric mean LOS (1.43; 95% CI 1.15-1.77 days) and higher rates of ED presentations (IRR: 1.12; 95% CI 1.04-1.21) compared with non-frail persons.
The CFS predicts community hospital-related outcomes in frail persons within a socioeconomic disadvantage area. Future intervention and allocation of resources could consider focusing on CFS 4-6 as a priority for frail persons within a community hospital setting.
临床虚弱量表（CFS）可预测与医院相关的结局。在社会经济劣势地区，虚弱更为常见，但尚无研究专门报告 CFS 对已知社会经济劣势地区与医院相关结局的影响。
评估 CFS 与与医院相关结局的关联。
在澳大利亚一个弱势地区的社区医院进行的回顾性观察性研究（社会经济指数区域=0.1%）。
在急诊科（ED）使用 CFS 评估年龄≥75 岁的人群。将虚弱定义为评分≥4。使用回归分析评估 CFS 与死亡率、入院率、ED 就诊次数和住院时间（LOS）之间的关联。
在 2017 年 7 月 11 日至 2018 年 3 月 31 日期间，有 5151 例 ED 就诊涉及 3258 名年龄≥75 岁的患者。虚弱者比非虚弱者年龄更大，更有可能到 ED 就诊并出现谵妄。CFS 与 28 天死亡率独立相关，CFS 每增加一个单位，死亡率增加 1.5 倍（95%CI：1.3-1.7）。CFS 为 4-6 分的虚弱者更有可能入院（比值比：1.2；95%CI：1.0-1.5），具有更高的平均 LOS（1.43；95%CI 1.15-1.77 天）和更高的 ED 就诊率（发病率比：1.12；95%CI 1.04-1.21）与非虚弱者相比。
CFS 可预测社会经济劣势地区社区医院相关结局的虚弱者。未来的干预和资源分配可以考虑将 CFS 4-6 作为社区医院环境中虚弱者的优先事项。
