Sunil Amin, MD, MPH, 1295 NW 14th Street, Suite A Miami, FL 33136, USA, Phone: (305) 243-8644, Fax: (305) 689-1820, Email:
J Frailty Aging. 2022;11(4):370-377. doi: 10.14283/jfa.2022.58.
Although frailty is a known predictor of mortality and complications across various disease states, it remains an understudied topic among patients with acute pancreatitis (AP).
Our aim was to assess the impact of frailty on outcomes in patients with AP.
Retrospective cohort study.
Appended data was obtained from the 2016-2017 National Inpatient Sample (NIS) database.
574,895 adult patients with a primary discharge diagnosis of AP.
We performed a nationwide cohort study utilizing International Classification of Diseases (ICD) diagnostic codes to identify adult patients with AP. The Hospital Frailty Risk Score (HFRS) was used to classify patients as frail or non-frail. The primary outcome was complications related to AP including all-cause mortality. Secondary outcomes were length of stay and total hospitalization costs. Multivariable logistic regression models were used to determine the association between frailty and complications.
574,895 patients were represented; 24.7% (141,999) characterized as frail and 75.3% (432,896) as non-frail. 26.7% of frail patients suffered composite complications related to AP versus 13.3% of non-frail patients (P < 0.001). Frail patients had more cardiovascular, pulmonary, gastrointestinal, and infectious adverse events compared to non-frail patients. Frail patients also had higher mortality rates (2.0% vs 0.1% P < 0.001), increased length of stay (6.5 days vs 3.6, P < 0.001) and total hospitalization charges ($60,136 vs $31,095, P < 0.001). On multivariable analysis, positive frailty status was associated with 2.33 times increased odds of having composite complications.
Frailty assessments can be utilized as an adjunct to validated scoring systems to improve risk stratification and clinical management of patients with AP.
尽管虚弱是各种疾病状态下死亡率和并发症的已知预测因素，但在急性胰腺炎 (AP) 患者中，它仍然是一个研究不足的课题。
我们旨在评估虚弱对 AP 患者结局的影响。
回顾性队列研究。
从 2016-2017 年全国住院患者样本 (NIS) 数据库中获取附加数据。
574,895 名患有原发性 AP 出院诊断的成年患者。
我们进行了一项全国性队列研究，使用国际疾病分类 (ICD) 诊断代码来识别患有 AP 的成年患者。使用医院虚弱风险评分 (HFRS) 将患者分为虚弱或非虚弱。主要结局是与 AP 相关的并发症，包括全因死亡率。次要结局是住院时间和总住院费用。多变量逻辑回归模型用于确定虚弱与并发症之间的关联。
共纳入 574,895 例患者；24.7%（141,999 例）为虚弱，75.3%（432,896 例）为非虚弱。26.7%的虚弱患者发生与 AP 相关的复合并发症，而非虚弱患者为 13.3%（P<0.001）。与非虚弱患者相比，虚弱患者有更多的心血管、肺部、胃肠道和感染不良事件。虚弱患者的死亡率也更高（2.0%比 0.1%，P<0.001），住院时间更长（6.5 天比 3.6 天，P<0.001），总住院费用更高（60,136 美元比 31,095 美元，P<0.001）。多变量分析显示，虚弱状态呈阳性与复合并发症的发生几率增加 2.33 倍相关。
虚弱评估可作为验证评分系统的辅助手段，以改善 AP 患者的风险分层和临床管理。
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