Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia.
Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia; Department of Rehabilitation Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, the Netherlands.
Mech Ageing Dev. 2022 Oct;207:111712. doi: 10.1016/j.mad.2022.111712. Epub 2022 Jul 26.
Frailty is prevalent amongst geriatric inpatients and worsens clinical outcomes. Determinants of admission frailty and changes in frailty severity are potential targets for intervention.
To identify characteristics associated with frailty severity at admission and change in frailty severity during geriatric rehabilitation.
The observational, prospective, longitudinal inception cohort REStORing health of acutely unwell adulTs (RESORT) includes geriatric rehabilitation inpatients. Demographic, medical, nutritional, functional, and psychological characteristics were analysed according to admission Clinical Frailty Scale. Linear and multinomial logistic regression prediction models identified admission characteristics predicting change in frailty severity during rehabilitation.
A total 1716 inpatients (median age [IQR] 83.4 [77.7-88.6] years, 56.4 % females) were included. Poorer admission medical, nutritional, functional, and psychological status was associated with more severe frailty. Cardiac admissions, higher Cumulative Illness Rating Scale, greater number of medications, and better Short Physical Performance Battery at admission predicted improved frailty severity. Admission cognitive impairment, delirium, higher Charlson Comorbidity Index, and Hospital Anxiety and Depression Scale anxiety predicted worsened frailty severity. Explained variation was low.
Frailer geriatric rehabilitation inpatients have more complicated disease and impaired nutritional, physical, and psychological markers. Admission cognitive impairment, delirium, comorbidity, and anxiety predict worsening frailty during rehabilitation, and require prompt management.
衰弱在老年住院患者中很常见，并且会使临床结局恶化。入院时衰弱的决定因素以及衰弱严重程度的变化是潜在的干预目标。
确定与入院时衰弱严重程度以及老年康复期间衰弱严重程度变化相关的特征。
观察性、前瞻性、纵向起始队列 REStORing health of acutely unwell adulTs（RESORT）纳入了老年康复住院患者。根据入院时的临床虚弱量表分析人口统计学、医学、营养、功能和心理特征。线性和多项逻辑回归预测模型确定了入院时的特征，这些特征预测了康复期间衰弱严重程度的变化。
共纳入 1716 名住院患者（中位数年龄 [IQR] 83.4 [77.7-88.6] 岁，56.4%为女性）。入院时较差的医学、营养、功能和心理状况与更严重的衰弱相关。心脏入院、更高的累积疾病评分量表、更多的药物以及入院时更好的简短体能表现电池预测了衰弱严重程度的改善。入院时的认知障碍、谵妄、更高的 Charlson 合并症指数和医院焦虑和抑郁量表焦虑预测了衰弱严重程度的恶化。解释的变异度较低。
衰弱程度更严重的老年康复住院患者具有更复杂的疾病和受损的营养、身体和心理标志物。入院时的认知障碍、谵妄、合并症和焦虑预测了康复期间衰弱的恶化，需要及时管理。
