National Center for Geriatrics and Gerontology, 7-430 Morioka-cho, Obu, 474-8511, Aichi, Japan.
BMC Geriatr. 2023 Jul 13;23(1):433. doi: 10.1186/s12877-023-04133-4.
BACKGROUND: The spread of the novel severe acute respiratory syndrome coronavirus 2 infection has been prolonged, with the highly contagious Omicron variant becoming the predominant variant by 2022. Many patients admitted to dedicated coronavirus disease 2019 (COVID-19) wards (COVID-19 treatment units) develop disuse syndrome while being treated in the hospital, and their ability to perform activities of daily living declines, making it difficult for hospitals to discharge them. This study aimed to investigate the relationship between the degree of frailty and home discharge of patients admitted to a COVID-19 treatment units. METHODS: This study retrospectively examined the in-patient medical records of 138 patients (82.7 ± 7.6 years old) admitted to a COVID-19 treatment unit from January to December 2022. The end-point was to determine the patients' ability to be discharged from the unit directly to home; such patients were classified into the 'Home discharge' group and compared with those in the 'Difficulty in discharge' group. The degree of frailty was determined based on the Clinical Frailty Scale (CFS), and the relationship with the endpoint was analysed. A receiver operating characteristic (ROC) curve was created and the cut-off value was calculated with the possibility of home discharge as the state variable and CFS as the test variable. Logistic regression analysis was conducted with the possibility of home discharge as the dependent variable and CFS as the independent variable. RESULTS: There were 75 patients in the Home discharge group and 63 in the Difficulty in discharge group. ROC analysis showed a CFS cut-off value of 6 or more, with a sensitivity of 70.7% and a specificity of 84.1%. The results of the logistic regression analysis showed a significant correlation between possibility of home discharge and CFS even after adjusting for covariates, with an odds ratio of 13.44. CONCLUSIONS: Based on the evaluation of the degree of frailty conducted in the COVID-19 treatment unit, it was possible to accurately predict whether a patient could be discharged directly to home after treatment CFS could be an effective screening tool to easily detect patients requiring ongoing hospitalisation even after the acute phase of treatment.
背景:新型严重急性呼吸综合征冠状病毒 2 感染的传播时间延长,到 2022 年,高传染性的奥密克戎变异株成为主要变异株。许多入住专门的 2019 年冠状病毒病(COVID-19)病房(COVID-19 治疗单位)的患者在住院治疗期间会出现废用综合征,日常生活活动能力下降,导致医院难以出院。本研究旨在探讨 COVID-19 治疗单位住院患者虚弱程度与出院回家之间的关系。
方法:本研究回顾性分析了 2022 年 1 月至 12 月期间入住 COVID-19 治疗单位的 138 名患者(82.7±7.6 岁)的住院病历。终点是确定患者是否能够直接从单位出院回家;符合出院条件的患者分为“直接出院”组,并与“难以出院”组进行比较。根据临床虚弱量表(CFS)确定虚弱程度,并分析与终点的关系。以出院回家的可能性为状态变量,CFS 为检验变量绘制受试者工作特征(ROC)曲线,并计算截断值。以出院回家的可能性为因变量,CFS 为自变量进行逻辑回归分析。
结果:直接出院组 75 例,难以出院组 63 例。ROC 分析显示,CFS 截断值为 6 或以上,灵敏度为 70.7%,特异性为 84.1%。逻辑回归分析结果显示,在校正协变量后,出院回家的可能性与 CFS 之间仍存在显著相关性,优势比为 13.44。
结论:基于 COVID-19 治疗单位进行的虚弱程度评估,可以准确预测患者治疗后是否可以直接出院回家。CFS 可作为一种有效的筛查工具,有助于在治疗急性期后,及时发现需要继续住院治疗的患者。
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