Department of Emergency, Critical Care, and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, 2-5-1 Shikata, Okayama, 700-8558, Japan.
Department of Epidemiology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan.
Sci Rep. 2023 Apr 3;13(1):5433. doi: 10.1038/s41598-023-32519-2.
The aim of this study was to evaluate whether frailty was associated with 6-month mortality in older adults who were admitted to the intensive care unit (ICU) with an illness requiring emergency care. The investigation was a prospective, multi-center, observational study conducted among the ICUs of 17 participating hospitals. Patients ≥ 65 years of age who were admitted to the ICU directly from an emergency department visit were assessed to determine their baseline Clinical Frailty Scale (CFS) scores before the illness and were surveyed 6 months after admission. Among 650 patients included in the study, the median age was 79 years old, and overall mortality at 6 months was as low as 21%, ranging from 6.2% in patients with CFS 1 to 42.9% in patients with CFS ≥ 7. When adjusted for potential confounders, CFS score was an independent prognostic factor for mortality (one-point increase in CFS, adjusted risk ratio with 95% confidence interval 1.19 [1.09-1.30]). Quality of life 6 months after admission worsened as baseline CFS score increased. However, there was no association between total hospitalization cost and baseline CFS. CFS is an important predictor of long-term outcomes among critically ill older patients requiring emergent admission.
本研究旨在评估在因急症需要紧急护理而入住重症监护病房（ICU）的老年人中，衰弱与 6 个月死亡率之间的关系。该研究是一项前瞻性、多中心、观察性研究，在 17 家参与医院的 ICU 中进行。对年龄≥65 岁的患者进行评估，在疾病发生前评估其基线临床虚弱量表（CFS）评分，并在入院后 6 个月进行调查。在纳入研究的 650 名患者中，中位年龄为 79 岁，6 个月的总体死亡率低至 21%，从 CFS 1 的 6.2%到 CFS≥7 的患者的 42.9%不等。在调整潜在混杂因素后，CFS 评分是死亡率的独立预后因素（CFS 评分增加 1 分，调整后的风险比为 1.19[1.09-1.30]）。入院后 6 个月的生活质量随着基线 CFS 评分的增加而恶化。然而，总住院费用与基线 CFS 之间没有关联。CFS 是需要紧急入院的危重病老年患者长期预后的重要预测指标。
