缺铁与社区居住老年人住院率的关系：一项 DO-HEALTH 的 3 年前瞻性观察研究。

Association between iron deficiency and hospitalization rate in community-dwelling older adults: A 3-year prospective observational study of DO-HEALTH.

机构信息

Center on Aging and Mobility, University Hospital Zurich, Zurich City Hospital-Waid and University of Zurich, Zurich, Switzerland; Department of Aging Medicine and Aging Research, University Hospital Zurich and University of Zurich, Zurich, Switzerland.

Department of Aging Medicine and Aging Research, University Hospital Zurich and University of Zurich, Zurich, Switzerland.

出版信息

Am J Clin Nutr. 2023 Jan;117(1):12-21. doi: 10.1016/j.ajcnut.2022.11.001. Epub 2022 Dec 15.

DOI:10.1016/j.ajcnut.2022.11.001

PMID:36789930

Abstract

BACKGROUND

Iron deficiency (ID) is associated with negative health outcomes in older adults. However, data on the impact of ID on the number of hospitalizations and length of hospital stay (LOS) is lacking.

OBJECTIVE

To explore the associations between baseline ID and the number of hospitalizations and between baseline ID and at least one LOS ≥5 days in community-dwelling older adults.

METHODS

This is a secondary observational analysis of a randomized controlled trial including 2157 community-dwelling adults aged ≥70 years without major diseases at baseline. The main exposure was defined as ID (soluble transferrin receptor [sTfR] concentrations >28.1 nmol/L) at baseline. The primary outcome was the number of hospitalizations over a 3-year follow-up. The secondary outcome was having at least one LOS ≥5 days over the study period among individuals with one or more hospitalizations. Interaction between ID and anemia (hemoglobin <130 g/L for men and <120 g/L for women) was also investigated.

RESULTS

Baseline sTfR concentration was determined in 2141 participants (median age 74.0 years). At 3 year, 1497 hospitalizations were reported with an incidence rate of hospitalization of 0.26 per person-year (95% CI: 0.24, 0.28). Overall, baseline ID was associated with a 24% increased incidence rate of hospitalization (incidence rate ratio: 1.24; 95% CI: 1.05, 1.45) over 3 years. This association was independent of anemia status at baseline since the interaction between ID and anemia at baseline was not significant. Moreover, ID was not significantly associated with having a LOS ≥5 days (OR: 1.40; 95% CI: 1.00, 1.97) among participants with at least one hospitalization over 3 years.

CONCLUSIONS

ID is associated with increased hospitalization rate and not associated with LOS ≥5 days among generally healthy older adults. Efforts to minimize ID in older adults may improve overall health and optimize healthcare costs.

摘要

背景

铁缺乏症（ID）与老年人的健康不良后果有关。然而，缺乏关于 ID 对住院次数和住院时间（LOS）的影响的数据。

目的

探讨基线 ID 与住院次数之间的关系，以及基线 ID 与至少一次 LOS≥5 天之间的关系，在社区居住的老年人。

方法

这是一项对包括 2157 名无重大疾病的 70 岁以上社区居住成年人的随机对照试验的二次观察性分析。主要暴露定义为基线时的 ID（可溶性转铁蛋白受体[sTfR]浓度>28.1 nmol/L）。主要结局是在 3 年随访期间的住院次数。次要结局是在有一次或多次住院的个体中，在研究期间至少有一次 LOS≥5 天。还研究了 ID 与贫血（男性血红蛋白<130 g/L，女性血红蛋白<120 g/L）之间的相互作用。

结果

在 2141 名参与者中确定了基线 sTfR 浓度（中位年龄 74.0 岁）。在 3 年内，报告了 1497 例住院，住院率为 0.26 人/年（95%CI：0.24，0.28）。总体而言，基线 ID 与 3 年内住院率增加 24%相关（发病率比：1.24；95%CI：1.05，1.45）。由于基线 ID 和贫血之间的交互作用不显著，因此这种关联独立于基线时的贫血状态。此外，ID 与 3 年内至少有一次住院的患者的 LOS≥5 天无显著相关性（OR：1.40；95%CI：1.00，1.97）。