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临床虚弱量表可用于预测因冠状病毒病入院患者的出院返家情况。

Clinical frailty scale is useful in predicting return-to-home in patients admitted due to coronavirus disease.

机构信息

National Center for Geriatrics and Gerontology, 7-430 Morioka-cho, Obu, 474-8511, Aichi, Japan.

出版信息

BMC Geriatr. 2023 Jul 13;23(1):433. doi: 10.1186/s12877-023-04133-4.


DOI:10.1186/s12877-023-04133-4
PMID:37442988
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10347876/
Abstract

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.

摘要

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fa33/10347876/21417f8a37c9/12877_2023_4133_Figa_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fa33/10347876/0cb4b439d76b/12877_2023_4133_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fa33/10347876/21417f8a37c9/12877_2023_4133_Figa_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fa33/10347876/0cb4b439d76b/12877_2023_4133_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fa33/10347876/21417f8a37c9/12877_2023_4133_Figa_HTML.jpg

相似文献

[1]
Clinical frailty scale is useful in predicting return-to-home in patients admitted due to coronavirus disease.

BMC Geriatr. 2023-7-13

[2]
[A 180-day mortality predictive score based on frailty syndrome in elderly patients with sepsis: a Logistic regression analysis model].

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[3]
Association between Clinical Frailty Scale score and hospital mortality in adult patients with COVID-19 (COMET): an international, multicentre, retrospective, observational cohort study.

Lancet Healthy Longev. 2021-3

[4]
Increased care at discharge from COVID-19: The association between pre-admission frailty and increased care needs after hospital discharge; a multicentre European observational cohort study.

BMC Med. 2020-12-18

[5]
Age, Frailty, and Comorbidity as Prognostic Factors for Short-Term Outcomes in Patients With Coronavirus Disease 2019 in Geriatric Care.

J Am Med Dir Assoc. 2020-8-14

[6]
Frailty predicts failure to discharge patients home from a subacute-care unit: a 3-year Italian experience.

Aging Clin Exp Res. 2022-1

[7]
The effect of frailty on survival in patients with COVID-19 (COPE): a multicentre, European, observational cohort study.

Lancet Public Health. 2020-6-30

[8]
Association between Clinical Frailty Scale (CFS) and clinical presentation and outcomes in older inpatients with COVID-19.

BMC Geriatr. 2023-1-2

[9]
Frailty and outcomes from pneumonia in critical illness: a population-based cohort study.

Br J Anaesth. 2020-9-3

[10]
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J Vasc Surg. 2018-11

引用本文的文献

[1]
Frailty and Energy Intake Deficiency Reduce the Efficiency of Activities of Daily Living in Patients with Musculoskeletal Disorders: A Retrospective Cohort Study.

Nutrients. 2025-4-12

[2]
Frailty assessment in critically ill older adults: a narrative review.

Ann Intensive Care. 2024-6-18

本文引用的文献

[1]
Medical comorbidities as predictors of COVID-19 short-term mortality: A historical cohort study in Indonesia.

Tzu Chi Med J. 2022-9-23

[2]
Frailty under COVID-19 pandemic in Japan: Changes in prevalence of frailty from 2017 to 2021.

J Am Geriatr Soc. 2023-5

[3]
Reduced renal function is associated with prolonged hospitalization in frail older patients with non-severe pneumonia.

Front Med (Lausanne). 2022-9-30

[4]
World guidelines for falls prevention and management for older adults: a global initiative.

Age Ageing. 2022-9-2

[5]
Prediction of the possibility of return to home based on frailty assessment at the time of admission to the COVID-19 treatment unit.

Geriatr Gerontol Int. 2022-9

[6]
The Future Evolution of the Mortality Acceleration Due to the COVID-19: The Charlson Comorbidity Index in Stochastic Setting.

Front Cardiovasc Med. 2022-7-14

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Correction: Prognostic factors for severity and mortality in patients infected with COVID-19: A systematic review.

PLoS One. 2022-5-26

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CARE frailty e-health scale: Association with incident adverse health outcomes and comparison with the Cardiovascular Health Study frailty scale in the NuAge cohort.

Maturitas. 2022-8

[9]
The Prevalence and Associated Risk Factors of Fear of Fall in the Elderly: A Hospital-Based, Cross-Sectional Study.

Cureus. 2022-3-25

[10]
Overview of the ethical guidelines for medical and biological research involving human subjects in Japan.

Jpn J Clin Oncol. 2022-5-31

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