Vainqueur Larissa, Simo-Tabue Nadine, Villeneuve Roxane, Dagonia Dorice, Bhakkan-Mambir Bernard, Mounsamy Ludwig, Delacroix Vaynome, Tabue-Teguo Maturin
CHU de Guadeloupe, Abymes, Guadeloupe.
Equipe ACTIVE, INSERM 1219, Université de Bordeaux, Bordeaux, France.
Front Med (Lausanne). 2022 Aug 12;9:963687. doi: 10.3389/fmed.2022.963687. eCollection 2022.
The COVID-19 pandemic has placed a tremendous stress on healthcare systems and caused reorganization. As the pandemic intensifies, identifying the profile of patients with COVID-19 was primordial in order to predict negative outcomes and organize healthcare resources. Age is associated with COVID-19's mortality, but for obvious ethical reasons, chronological age cannot be the sole criterion for predicting negative outcomes.
The objective of this study was to determine the relationship between frailty index (FI) and length of hospital stay, and death in a non-COVID population of patients aged 75 years old and above.
A retrospective, analytical, single-centered observational study was performed in the geriatric short-stay accommodation unit at Guadeloupe University Hospital. For this study, 158 patients who were at least 75 years old were recruited from November 2020 to May 2021. FI was calculated as the number of deficits in a participant divided by the total number of deficits considered (the cut-off of FI is.25 in outpatient). Multivariate logistics regression analyses were conducted to assess the association between frailty and death, and length of stay.
The average age of the participants was 85.7 ± 6.74 with a range of 75-104. Twenty-four of the patients died during hospitalization. FI was only significantly associated with mortality even after adjustment for age and gender (HR 26.3, 95% CI 1.7-413.4, = 0.021). The association was stronger in the highest tertile of the FI (age- and gender-adjusted HR 4.6, 95% CI 1.39-15.11, = 0.01). There was no significant interaction between FI and length of stay.
Our study shows an association between FI (in terms of age-related deficit accumulation) and mortality in a non-COVID geriatric short-stay unit in Guadeloupe. The FI seems to have a lower capacity to catch events such as length of stay in this very complex population. Further research studies have to be conducted for better understanding and investigation of our findings.
新冠疫情给医疗系统带来了巨大压力并导致了重组。随着疫情加剧，确定新冠患者的特征对于预测不良后果和组织医疗资源至关重要。年龄与新冠死亡率相关，但出于明显的伦理原因，实足年龄不能成为预测不良后果的唯一标准。
本研究的目的是确定衰弱指数（FI）与75岁及以上非新冠患者住院时间和死亡之间的关系。
在瓜德罗普大学医院的老年短期住宿病房进行了一项回顾性、分析性、单中心观察性研究。本研究从2020年11月至2021年5月招募了158名年龄至少75岁的患者。FI计算为参与者的缺陷数量除以所考虑的缺陷总数（门诊患者FI的临界值为0.25）。进行多因素逻辑回归分析以评估衰弱与死亡以及住院时间之间的关联。
参与者的平均年龄为85.7±6.74岁，范围为75 - 104岁。24名患者在住院期间死亡。即使在调整年龄和性别后，FI仅与死亡率显著相关（风险比26.3，95%置信区间为1.7 - 413.4，P = 0.021）。在FI最高三分位数中这种关联更强（年龄和性别调整后的风险比4.6，95%置信区间为1.39 - 15.11，P = 0.01）。FI与住院时间之间没有显著交互作用。
我们的研究表明在瓜德罗普的一个非新冠老年短期病房中，FI（就与年龄相关的缺陷积累而言）与死亡率之间存在关联。在这个非常复杂的人群中，FI似乎对诸如住院时间等事件的捕捉能力较低。必须进行进一步的研究以更好地理解和调查我们的发现。
