衰弱作为 COVID-19 患者接受 CPAP 治疗呼吸功能不全的死亡率预测指标。
Frailty as a predictor of mortality in COVID-19 patients receiving CPAP for respiratory insufficiency.
机构信息
Unit of General Medicine and Advanced Care, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, Milan, Italy.
Unit of Immunology, Rheumatology, Allergy and Rare Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy.
出版信息
Aging Clin Exp Res. 2022 Apr;34(4):945-949. doi: 10.1007/s40520-021-02070-z. Epub 2022 Mar 17.
OBJECTIVE
Exploring the association between frailty and mortality in a cohort of patients with COVID-19 respiratory insufficiency treated with continuous positive airway pressure.
METHODS
Frailty was measured using a Frailty Index (FI) created by using the baseline assessment data on comorbidities and body mass index and baseline blood test results (including pH, lactate dehydrogenase, renal and liver function, inflammatory indexes and anemia). FI > 0.25 identified frail individuals.
RESULTS
Among the 159 included individuals (81% men, median age of 68) frailty was detected in 69% of the patients (median FI score 0.3 ± 0.08). Frailty was associated to an increased mortality (adjusted HR 1.99, 95% CI 1.02-3.88, p = 0.04).
CONCLUSIONS
Frailty is highly prevalent among patients with COVID-19, predicts poorer outcomes independently of age. A personalization of care balancing the risk and benefit of treatments (especially the invasive ones) in such complex patients is pivotal.
目的
探讨使用基线合并症和体重指数评估数据及基线血液检查结果（包括 pH 值、乳酸脱氢酶、肾功能和肝功能、炎症指标和贫血）建立的衰弱指数（FI），评估 COVID-19 呼吸功能不全患者持续气道正压通气治疗后衰弱与死亡率的相关性。
方法
FI>0.25 定义为衰弱。
结果
在纳入的 159 名患者（81%为男性，中位年龄 68 岁）中，69%的患者存在衰弱（中位 FI 评分 0.3±0.08）。衰弱与死亡率增加相关（调整后的 HR 为 1.99，95%CI 为 1.02-3.88，p=0.04）。
结论
COVID-19 患者衰弱的发生率很高，衰弱独立于年龄预测更差的预后。在这些复杂患者中，平衡治疗风险和获益（尤其是侵入性治疗）的个体化护理至关重要。
Zotero 插件