Department of Medicine and Internal Medicine, Lausanne University Hospital (CHUV), Lausanne, Switzerland.
Age Ageing. 2021 Jun 28;50(4):1306-1313. doi: 10.1093/ageing/afaa278.
Frailty complicates management and worsens outcomes. We assessed the prevalence, determinants and consequences of frailty among elderly patients in a hospital setting.
Retrospective observational study in a Swiss university hospital.
22,323 patients aged ≥65 years hospitalized between January 2009 and December 2017 at the internal medicine ward were included. Frailty was defined by the Hospital Frailty Risk Score (HFRS) and patients were categorized as low (HFRS<5), intermediate (HFRS 5-15) and high (HFRS>15) risk.
Overall prevalence of intermediate and high risk of frailty was 43% and 20%, respectively; prevalence was higher in women and increased with age. Prevalence of high risk of frailty increased from 11.4% in 2009 to 31% in 2012, and decreased to 19.2% in 2017. After multivariable adjustment, frailty was associated with increased length of stay: average and (95% confidence interval) 11.9 (11.7-12.1), 15.6 (15.4-15.8) and 19.7 (19.3-20.1) days for low, intermediate and high risk, respectively, and increased likelihood of ICU stay: odds ratio (OR) and (95% CI) 1.57 (1.41-1.75) and 2.10 (1.82-2.42) for intermediate and high risk, respectively, p for trend <0.001. Frailty was associated with increased likelihood of hospital costs >70,000 CHF: OR and (95% CI) 3.46 (2.79-4.29) and 10.7 (8.47-13.6) for intermediate and high risk, respectively, p for trend <0.001, and with a lower likelihood of complete cost coverage: OR and (95% CI) 0.70 (0.65-0.76) and 0.52 (0.47-0.58) for intermediate and high risk, respectively, p for trend<0.001.
Frailty is a frequent condition among hospitalized patients and is associated with higher costs.
衰弱使管理复杂化并使预后恶化。我们评估了医院环境中老年患者衰弱的患病率、决定因素和后果。
瑞士一所大学医院的回顾性观察性研究。
2009 年 1 月至 2017 年 12 月，22323 名年龄≥65 岁的患者在内科病房住院，其中包括在内科病房住院的患者。衰弱通过医院衰弱风险评分（HFRS）定义，患者分为低危（HFRS<5）、中危（HFRS 5-15）和高危（HFRS>15）。
中间和高危的衰弱的总体患病率分别为 43%和 20%；女性和年龄较大的患者患病率较高。高危衰弱的患病率从 2009 年的 11.4%上升到 2012 年的 31%，到 2017 年下降到 19.2%。调整多变量后，衰弱与住院时间延长相关：低、中、高危的平均住院时间分别为 11.9（11.7-12.1）、15.6（15.4-15.8）和 19.7（19.3-20.1）天，入住 ICU 的可能性更高：中间和高危的比值比（OR）和（95%置信区间）分别为 1.57（1.41-1.75）和 2.10（1.82-2.42），p<0.001。衰弱与住院费用>70000 瑞士法郎的可能性增加相关：中间和高危的 OR 和（95%置信区间）分别为 3.46（2.79-4.29）和 10.7（8.47-13.6），p<0.001，与完全费用覆盖的可能性降低相关：中间和高危的 OR 和（95%置信区间）分别为 0.70（0.65-0.76）和 0.52（0.47-0.58），p<0.001。
衰弱是住院患者的常见病症，与更高的费用相关。
