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医院衰弱风险评分预测老年椎体压缩性骨折患者的不良事件:来自日本全国住院患者数据库的数据分析。

Hospital Frailty Risk Score predicts adverse events in older patients with vertebral compression fractures: Analysis of data in a nationwide in-patient database in Japan.

机构信息

Department of Nutrition, Hamamatsu City Rehabilitation Hospital, Hamamatsu, Japan.

Department of Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, Nagakute, Japan.

出版信息

Geriatr Gerontol Int. 2022 Mar;22(3):233-239. doi: 10.1111/ggi.14356. Epub 2022 Jan 31.

Abstract

AIMS

This study investigated the usefulness of frailty for predicting adverse events in patients with vertebral compression fractures (VCFs) during hospitalization using data obtained from the Japanese health insurance system.

METHODS

This retrospective cohort study of patients with VCFs aged ≥65 years was conducted using a nationwide database in Japan. We examined the relationships between frailty risk, classified using the Hospital Frailty Risk Score (HFRS), in-hospital mortality, and complications such as pressure ulcers and pneumonia. Multivariate logistic regression analysis was used to estimate the association between the HFRS and the outcomes of patients with VCFs.

RESULTS

In this study, the data of 30 980 in-patients with VCFs were analyzed. Of these patients, 76.8%, 21.3%, and 1.9% had low, intermediate, and high risks of frailty, respectively. The higher the risk of frailty, the higher the rate of in-hospital mortality and the occurrence of all complications (P < 0.001 for trend). An intermediate risk of frailty was independently associated with in-hospital mortality (odds ratio [OR], 1.421; P < 0.001), whereas a high risk of frailty did not show statistical significance (OR, 1.385; P = 0.150). Each frailty risk was independently associated with the occurrence of all complications during hospitalization.

CONCLUSIONS

The HFRS, which can assess the risk of frailty based on routinely collected medical records, was predictive of adverse events in older patients with VCFs based on a nationwide database in Japan. Future studies need to assess approaches to preventing adverse events in frail VCF patients. Geriatr Gerontol Int 2022; 22: 233-239.

摘要

目的

本研究利用日本健康保险系统获取的数据,探讨衰弱状况预测椎体压缩性骨折(VCF)患者住院期间不良事件的作用。

方法

本回顾性队列研究纳入了日本全国性数据库中年龄≥65 岁的 VCF 患者。我们分析了衰弱风险(采用医院衰弱风险评分[HFRS]进行分类)与住院期间死亡率以及压疮和肺炎等并发症之间的关系。多变量逻辑回归分析用于评估 HFRS 与 VCF 患者结局之间的关系。

结果

本研究共分析了 30980 例 VCF 住院患者的数据。这些患者中,低、中、高衰弱风险的比例分别为 76.8%、21.3%和 1.9%。衰弱风险越高,住院期间死亡率和所有并发症的发生率越高(趋势 P<0.001)。中度衰弱风险与住院期间死亡率独立相关(比值比[OR],1.421;P<0.001),而高度衰弱风险无统计学意义(OR,1.385;P=0.150)。每种衰弱风险均与住院期间所有并发症的发生独立相关。

结论

HFRS 可根据常规病历评估衰弱风险,基于日本全国性数据库,其可预测 VCF 老年患者的不良事件。未来的研究需要评估针对衰弱 VCF 患者预防不良事件的方法。

老年医学与老年健康国际杂志 2022;22:233-239

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