衰弱-老年综合评估脆弱指数（IF-VIG）对老年髋部骨折患者死亡率的预测能力
[Predictive capacity for mortality of the Frail-VIG index (IF-VIG) in old patients with hip fracture].
作者信息
Badosa-Collell Gemma, Latorre-Vallbona Nadina, Martori Joan Carles, Oller Ramon, Trullàs Joan Carles, Amblàs-Novellas Jordi
机构信息
Servicio de Medicina Interna y Atención a la Cronicidad, Hospital de Olot i comarcal de la Garrotxa, Olot, Girona, España; Laboratori de Reparació i Regeneració Tissular (TR2Lab), Facultat de Medicina, Universitat de Vic-Universitat Central de Catalunya, Vic, Barcelona, España.
Grupo de Investigación en Cronicidad de la Cataluña Central (C3RG), Universitat de Vic-Universitat Central de Catalunya, Vic, Barcelona, España; Servei Territorial de Geriatria i Cures Pal·liatives, Hospital Universitario de la Santa Creu de Vic, Vic, Barcelona, España.
出版信息
Rev Esp Geriatr Gerontol. 2022 Jul-Aug;57(4):220-223. doi: 10.1016/j.regg.2022.05.002. Epub 2022 May 31.
INTRODUCTION
Frailty and hip fracture are closely related and are associated with high risk of functional decline and mortality. The objective of this study is to analyze whether the Frail-VIG index [IF-VIG] (fragility index validated in the geriatric population) maintains its predictive capacity for mortality in old patients with hip fracture.
METHODS
Observational, cohort, longitudinal and ambispective study on patients admitted to an acute geriatric unit with a hip fracture. Patients were classified according to their degree of frailty into three groups by the IF-VIG: no frailty/initial frailty (≤0.35), moderate frailty (0.36-0.50) and advanced frailty (>0.50). The follow-up period was 24months. The three groups were compared using survival curves and ROC curves were analyzed to assess the prognostic capacity of IF-VIG.
RESULTS
A total of 103 patients were included; 73.8% were women, with a mean age of 87years. There were no differences between groups in relation to the type of fracture, the kind of surgery, the waiting time until surgery and the mobilization time. Overall, in-hospital mortality was 7.76%, significantly higher in the advanced frailty group (23.3%). We also found significant differences in mortality at 24months of follow-up according to the IF-VIG. The under the ROC curve area at 3, 6, 12 and 24months was 0.90 (0.83-0.97), 0.90 (0.82-0.97), 0.91 (0.86-0.97) and 0.88 (0.81-0.94), respectively.
CONCLUSION
The IF-VIG appears to be a good tool in predicting mortality in old patients with hip fracture.
引言
衰弱与髋部骨折密切相关，且与功能衰退和死亡的高风险相关。本研究的目的是分析衰弱 - VIG指数[IF - VIG]（在老年人群中验证的脆弱指数）在老年髋部骨折患者中是否保持其对死亡率的预测能力。
方法
对入住急性老年病房的髋部骨折患者进行观察性、队列、纵向和双向研究。根据IF - VIG将患者按衰弱程度分为三组：无衰弱/初始衰弱（≤0.35）、中度衰弱（0.36 - 0.50）和重度衰弱（>0.50）。随访期为24个月。使用生存曲线对三组进行比较，并分析ROC曲线以评估IF - VIG的预后能力。
结果
共纳入103例患者；73.8%为女性，平均年龄87岁。在骨折类型、手术方式、手术等待时间和活动时间方面，各组之间无差异。总体而言，住院死亡率为7.76%，在重度衰弱组中显著更高（23.3%）。我们还发现根据IF - VIG在随访24个月时死亡率存在显著差异。在3、6、12和24个月时ROC曲线下面积分别为0.90（0.83 - 0.97）、0.90（0.82 - 0.97）、0.91（0.86 - 0.97）和0.88（0.81 - 0.94）。
结论
IF - VIG似乎是预测老年髋部骨折患者死亡率的良好工具。
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