Jung Hee-Won, Baek Ji Yeon, Kwon Young Hye, Jang Il-Young, Kim Dae Yul, Kwon Hyouk-Soo, Lee Sun Hee, Oh Hyun Jin, Lee Eunju, Koh Younsuck
Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
Department of Nursing, Asan Medical Center, Seoul, South Korea.
Front Med (Lausanne). 2022 Jul 6;9:929555. doi: 10.3389/fmed.2022.929555. eCollection 2022.
While the Clinical Frailty Scale (CFS) has been extensively validated for predicting health outcomes in older adults, the role of the at-point CFS at the time of examination is unclear. We aimed to examine the ability of the at-point CFS for predicting clinical outcomes of older inpatients.
As a single-center and prospective cohort study, we enrolled 1,016 older adults who were 65 years or older and were admitted to one of 9 medical or surgical units from May 2021 to September 2021. The associations of the at-point CFS with outcomes of falls, delirium, pressure ulcers, 30-day unplanned readmission and/or emergency department (ED) visits, institutionalization, and a composite outcome were analyzed.
In the study population ( = 1,016), 26 patients had incident pressure ulcers, 6 patients had falls, 50 patients experienced delirium, and 13 patients died during hospitalization. Also, 37 patients experienced an ED visit and 22 patients had an unplanned readmission within 30 days after discharge. The composite outcome was 1.7% among patients with the CFS < 5 and 28.5% among patients with the CFS ≥ 5. The higher CFS was associated with an increased risk of a fall [odds ratio (OR) 1.74 (1.01-3.01)], pressure ulcers [OR 3.02 (2.15-4.23)], delirium [OR 2.72 (2.13-3.46)], 30-day readmission [OR 1.94 (1.44-2.62)], ED visit [OR 1.81 (1.47-2.23)], death [OR 3.27 (2.02-5.29)], and institutionalization after discharge [OR 1.88 (1.62-2.18)].
The at-point CFS assessed in older inpatients can screen high-risk individuals who might experience adverse geriatric conditions and in-hospital outcomes.
虽然临床衰弱量表（CFS）已被广泛验证可用于预测老年人的健康结局，但检查时即时CFS的作用尚不清楚。我们旨在研究即时CFS预测老年住院患者临床结局的能力。
作为一项单中心前瞻性队列研究，我们纳入了1016名65岁及以上的老年人，他们于2021年5月至2021年9月入住9个内科或外科病房之一。分析了即时CFS与跌倒、谵妄、压疮、30天非计划再入院和/或急诊科就诊、入住机构以及综合结局之间的关联。
在研究人群（n = 1016）中，26例患者发生了新发压疮，6例患者跌倒，50例患者出现谵妄，13例患者在住院期间死亡。此外，37例患者到急诊科就诊，22例患者在出院后30天内非计划再入院。CFS < 5的患者综合结局发生率为1.7%，CFS≥5的患者为28.5%。较高的CFS与跌倒风险增加[比值比（OR）1.74（1.01 - 3.01）]、压疮[OR 3.02（2.15 - 4.23）]、谵妄[OR 2.72（2.13 - 3.46）]、30天再入院[OR 1.94（1.44 - 2.62）]、急诊科就诊[OR 1.81（1.47 - 2.23）]、死亡[OR 3.27（2.02 - 5.29）]以及出院后入住机构[OR 1.88（1.62 - 2.18）]相关。
在老年住院患者中评估的即时CFS可以筛查出可能经历不良老年状况和住院结局的高危个体。
