Emergency Department, University Hospital Basel, Petersgraben 2, 4031 Basel, Switzerland.
Am J Emerg Med. 2022 Sep;59:111-117. doi: 10.1016/j.ajem.2022.06.046. Epub 2022 Jun 26.
Symptoms may differ between frail and non-frail patients presenting to Emergency Departments (ED). However, the association between frailty status and type of presenting symptoms has not been investigated. We aimed to systematically analyse presenting symptoms in frail and non-frail older emergency patients and hypothesized that frailty may be associated with nonspecific complaints (NSC), such as generalised weakness.
Secondary analysis of a prospective, single centre, observational all-comer cohort study conducted in the ED of a Swiss tertiary care hospital. All presentations of patients aged 65 years and older were analysed. At triage, presenting symptoms and frailty were systematically assessed using a questionnaire. Patients with a Clinical Frailty Scale (CFS) > 4 were considered frail. Presenting symptoms, stratified by frailty status, were analysed. The association between frailty and generalised weakness was tested by logistic regression.
Overall, 2'416 presentations of patients 65 years and older were analysed. Mean age was 78.9 (SD 8.4) years, 1'228 (50.8%) patients were female, and 885 (36.6%) patients were frail (CFS > 4). Generalised weakness, dyspnea, localised weakness, speech disorder, loss of consciousness and gait disturbance were recorded more often in frail patients, whereas chest pain was reported more often by non-frail patients. Generalised weakness was reported as presenting symptom in 166 (18.8%) frail patients and in 153 (10.0%) non-frail patients. Frailty was associated with generalised weakness after adjusting for age, gender and elevated National Early Warning Score 2 (NEWS) ≥ 3 (OR 1.19, CI 1.10-1.29, p < 0.001).
Presenting symptoms differ in frail and non-frail patients. Frailty is associated with generalised weakness at ED presentation.
在前往急诊部（ED）的虚弱和非虚弱患者之间，症状可能存在差异。然而，虚弱状态与表现症状类型之间的关联尚未得到研究。我们旨在系统地分析脆弱和非脆弱老年急诊患者的表现症状，并假设虚弱可能与非特异性投诉（NSC）相关，例如全身性乏力。
对瑞士三级护理医院 ED 进行的前瞻性、单中心、观察性所有患者队列研究的二次分析。分析了所有 65 岁及以上患者的表现。在分诊时，使用问卷系统地评估表现症状和虚弱程度。使用临床虚弱量表（CFS）>4 的患者被认为是虚弱的。按虚弱状态分层分析表现症状。通过逻辑回归测试虚弱与全身性乏力之间的关联。
总体而言，分析了 2416 名 65 岁及以上患者的就诊情况。平均年龄为 78.9（8.4）岁，1228 名（50.8%）患者为女性，885 名（36.6%）患者为虚弱（CFS>4）。全身性乏力、呼吸困难、局部性乏力、言语障碍、意识丧失和步态障碍在虚弱患者中更为常见，而非虚弱患者则更常报告胸痛。166 名（18.8%）虚弱患者和 153 名（10.0%）非虚弱患者报告有全身性乏力作为表现症状。在调整年龄、性别和升高的国家早期预警评分 2（NEWS）≥3 后，虚弱与全身性乏力相关（OR 1.19，CI 1.10-1.29，p<0.001）。
虚弱和非虚弱患者的表现症状存在差异。虚弱与 ED 就诊时的全身性乏力相关。
