Department of Geriatric & Palliative Medicine, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, Denmark; CopenAge, Copenhagen Center for Clinical Age Research, Faculty of Health and Medical Sciences, Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
Department of Geriatric & Palliative Medicine, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, Denmark; CopenAge, Copenhagen Center for Clinical Age Research, Faculty of Health and Medical Sciences, Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; Department of Emergency Medicine, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, Denmark.
J Am Med Dir Assoc. 2023 Dec;24(12):1898-1903. doi: 10.1016/j.jamda.2023.07.002. Epub 2023 Aug 8.
Older patients are typically underrepresented in clinical trials despite representing a major proportion of the patient population. We aim to describe the feasibility of performing body composition measures, physical function measures, and patient-reported questionnaires within the first 24 hours of admission in a large sample of older acutely admitted medical patients. In addition, we aim to characterize patients with missing measurements.
Secondary analyses of cross-sectional data from a cohort study.
A total of 1071 acutely admitted patients aged ≥65 years from the acute medical ward at Bispebjerg Hospital, were enrolled within the first 24 hours of hospitalization.
Body composition was investigated using direct segmental multifrequency bioelectrical impedance analyses (DSM-BIA) and physical function was assessed using hand grip strength (HGS) and the 30-second sit-to-stand test (STS). The orientation-memory-concentration test (OMC) was used to evaluate the prevalence of cognitive impairments within 24 hours of hospitalization, and the OMC in conjunction with the Strength, Assistance walking, Rise from a chair, Climb stairs, and Falls questionnaire (SARC-F) was used to assess the feasibility of patient-reported outcomes (PROs).
Mean age was 78.8 ± 7.8 years (53.0% female). HGS was performed in 96.2% of the enrolled patients, whereas the PRO, 30-second STS, and DSM-BIA were performed in 91.2%, 69.2%, and 59.8% of patients, respectively. The main barrier for performing the 30-second STS and body composition measurements was an inability to mobilize the patient from the hospital bed.
The assessment of HGS and PROs show excellent feasibility in clinical research including older patients, even when the patients are enrolled and tested within 24 hours of an acute admission. Assessments of DSM-BIA and the 30-second STS show good feasibility but are less feasible in immobile patients often presenting as more frail, weaker, and cognitively impaired.
尽管老年患者在患者群体中占很大比例，但在临床试验中他们的代表性通常不足。我们旨在描述在大型急性入院老年医学患者样本中，在入院后 24 小时内进行身体成分测量、身体功能测量和患者报告问卷的可行性。此外，我们旨在描述测量值缺失的患者特征。
队列研究的横断面数据的二次分析。
共有 1071 名年龄≥65 岁的急性入院患者在比斯加夫医院的急性内科病房入院后 24 小时内入组。
使用直接节段多频生物电阻抗分析（DSM-BIA）进行身体成分研究，使用手握力（HGS）和 30 秒坐站测试（STS）评估身体功能。定向记忆浓度测试（OMC）用于评估入院后 24 小时内认知障碍的患病率，OMC 结合力量、辅助行走、从椅子上站起来、爬楼梯和跌倒问卷（SARC-F）用于评估患者报告结局（PROs）的可行性。
平均年龄为 78.8±7.8 岁（53.0%为女性）。纳入的患者中 96.2%进行了 HGS，91.2%、69.2%和 59.8%的患者进行了 PRO、30 秒 STS 和 DSM-BIA。进行 30 秒 STS 和身体成分测量的主要障碍是无法将患者从病床移动。
即使在急性入院后 24 小时内入组和测试，HGS 和 PRO 的评估在包括老年患者在内的临床研究中具有极好的可行性。DSM-BIA 和 30 秒 STS 的评估具有良好的可行性，但在不能移动的患者中不太可行，这些患者通常表现为更虚弱、更弱和认知障碍。
