Kim Yeon-Pyo, Choe Yu-Ri, Park Jong-Heon, Kim Sunyoung, Won Chang-Won, Hwang Hwan-Sik
Department of Family Medicine, Chonnam National University Hwasun Hospital, 322-Seoyang-ro, Hwasun-eup, Hwasun-Gun, Jeollanam-do, 58128, South Korea.
Big Data Screening Department, National Health Insurance Service, 32, Geongang-ro, Wonju-Si, Gangwon-do, 26464, South Korea.
Eur Geriatr Med. 2019 Jun;10(3):403-411. doi: 10.1007/s41999-019-00196-y. Epub 2019 Apr 30.
To assess the association between frailty, measured using a frailty diagnosis tool, and adverse outcomes using regular health checkup data and National Health Insurance claim data of 66-year-old Koreans.
We evaluated all Koreans born between 1942 and 1946 who received a 66-year lifetime transition period health examination and regular biennial general and cancer screenings between 2008 and 2012. These patients were observed until December 31, 2015. The Lifetime Transition Period Health Examination version of the Korean Frailty Index (THE frailty index) was used to examine adverse geriatric outcomes based on levels of frailty. THE frailty index scores were used to classify participants as "robust" (0-2), "pre-frail" (3-4), or "frail" (more than 5). The main outcomes included the risks of all-cause mortality, long-term care facility institutionalization, and hip fracture.
Among 725,759 Korean men and women, the prevalence of frail and pre-frail conditions was 3.4% and 26.6%, respectively. After an average of 4.4 years of follow-up, frail older persons had significantly higher mortality rates [men: hazard ratio (HR) 2.031 (95% confidence interval [CI], 1.894-2.178); women: HR 2.092 (95% CI 1.920-2.279)], long-term care facility institutionalization [men: HR 2.997 (95% CI 2.750-3.268); women: HR 3.057 (95% CI 2.866-3.261)], and hip fracture [men: HR 2.230 (95% CI 1.854-2.681); women: HR 2.356 (95% CI 2.086-2.660)] than those of robust older persons.
Aged frail persons diagnosed using the THE frailty index had higher all-cause mortality, more frequent entry into long-term care facilities, and greater risk of hip fracture.
利用衰弱诊断工具评估衰弱与不良结局之间的关联，研究对象为66岁韩国人的定期健康检查数据和国民健康保险索赔数据。
我们评估了所有在1942年至1946年出生的韩国人，这些人在2008年至2012年期间接受了66岁终身过渡期健康检查以及定期的两年一次的常规和癌症筛查。对这些患者进行观察直至2015年12月31日。采用韩国衰弱指数的终身过渡期健康检查版本（THE衰弱指数），根据衰弱程度来检查老年不良结局。THE衰弱指数得分用于将参与者分为“强健”（0 - 2分）、“衰弱前期”（3 - 4分）或“衰弱”（超过5分）。主要结局包括全因死亡率、长期护理机构入住率和髋部骨折风险。
在725,759名韩国男性和女性中，衰弱和衰弱前期状况的患病率分别为3.4%和26.6%。平均随访4.4年后，衰弱的老年人的死亡率显著更高[男性：风险比（HR）2.031（95%置信区间[CI]，1.894 - 2.178）；女性：HR 2.092（95% CI 1.920 - 2.279）]，长期护理机构入住率[男性：HR 2.997（95% CI 2.750 - 3.268）；女性：HR 3.057（95% CI 2.866 - 3.261）]，以及髋部骨折[男性：HR 2.230（95% CI 1.854 - 2.681）；女性：HR 2.356（95% CI 2.086 - 2.660）]均高于强健的老年人。
使用THE衰弱指数诊断的老年衰弱者全因死亡率更高，进入长期护理机构的频率更高，髋部骨折风险更大。
