衰弱评估工具-新量表（FRAIL-NH）预测机构老年人群死亡：来自中等收入国家的纵向研究。

Prediction of Death with the FRAIL-NH in Institutionalized Older Adults: A Longitudinal Study from a Middle-Income Country.

机构信息

Ivan Aprahamian, MD, MS, PhD, FACP. Group of Investigation on Multimorbidity and Mental Health in Aging (GIMMA), Division of Geriatrics, Department of Internal Medicine, Faculty of Medicine of Jundiaí. 250 Francisco Telles st. ZIP 13202-550. Jundiaí, Brazil.E-mail:

出版信息

J Nutr Health Aging. 2020;24(8):817-820. doi: 10.1007/s12603-020-1464-7.

DOI:10.1007/s12603-020-1464-7

PMID:33009530

Abstract

BACKGROUND/OBJECTIVES: Frailty is common in nursing homes. However, few studies reported longitudinal validation for death prediction or cut-off scores with the FRAIL-NH, which is designed to be used in nursing homes. Moreover, no studies came from Latin America, where frailty is highly prevalent. Our objectives were to evaluate (1) the prevalence of frailty according to the FRAIL-NH scale, and (2) its association to and the best cut-off score for predicting death after 12 months.

DESIGN

longitudinal study with 12-month follow-up.

SETTING

6 nursing homes in southwest of Brazil.

PARTICIPANTS

293 residents with 60 years old or more.

METHODS

Frailty was evaluated through the FRAIL-NH scale. Logistic regression was used to estimate the associated between frailty and mortality adjusted for age and sex. ROC curve was used to evaluate the accuracy of the scale for mortality prediction.

RESULTS

Frailty was prevalent (47.4%) and was associated with death (odds ratio=1.31, 95% confidence interval [CI]=1.18-1.48, p<0.001). The area under the curve was 0.741 (95%CI=0.68-0.79). The sensitivity and specificity of the FRAIL-NH scale according to the best value of the Youden Index was 72.9% and 66.5%, respectively, for a cut-off > 8 points.

CONCLUSIONS

Frailty is prevalent in nursing homes according to the FRAIL-NH and it was associated with one-year prediction of death for a cut-off > 8 points.

摘要

背景/目的：衰弱在养老院中很常见。然而，很少有研究报告使用专门为养老院设计的 FRAIL-NH 量表进行死亡预测或截断评分的纵向验证。此外，没有来自衰弱发病率高的拉丁美洲的研究。我们的目标是评估：(1) 根据 FRAIL-NH 量表评估衰弱的流行率；(2) 衰弱与 12 个月后死亡的相关性及其最佳截断评分。

设计

12 个月随访的纵向研究。

地点

巴西西南部的 6 家养老院。

参与者

60 岁及以上的 293 名居民。

方法

通过 FRAIL-NH 量表评估衰弱。使用逻辑回归估计衰弱与死亡率之间的关联，并调整年龄和性别因素。ROC 曲线用于评估量表对死亡率预测的准确性。

结果

衰弱的患病率较高（47.4%），与死亡相关（比值比=1.31，95%置信区间[CI]=1.18-1.48，p<0.001）。曲线下面积为 0.741（95%CI=0.68-0.79）。根据 Youden 指数最佳值，FRAIL-NH 量表的灵敏度和特异性分别为 72.9%和 66.5%，截断值>8 分。