Operative Research Unit of Internal Medicine, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128, Rome, Italy.
Department of Medicine and Surgery, Internship Program in Geriatrics, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, 00128, Rome, Italy.
Aging Clin Exp Res. 2023 Nov;35(11):2573-2581. doi: 10.1007/s40520-023-02535-3. Epub 2023 Aug 29.
Frailty associates with increased vulnerability to adverse health outcomes and reduced tolerance to medical interventions. Its impact on patients with chronic respiratory diseases, particularly beyond chronic obstructive pulmonary disease (COPD), remains poorly understood.
To evaluate the association between frailty index and 5-year mortality across different "spirometric" patterns and the variation in their occurring frailty determinants.
This study analyzed data from the SARA study, which enrolled 1968 older adults, to evaluate the association between frailty and 5-year mortality across different spirometric patterns. Frailty was assessed using the frailty index (FI), and spirometry was performed to determine lung function patterns. Hazard ratios (HRs) were calculated using Cox regression models, adjusting for age and sex.
Among the study participants, 16% were classified as frail. Frailty was associated with a significantly increased risk of mortality across all spirometric patterns. The 5-year mortality rates were 34.3% in subjects with normal spirometry, 45.1% in those with obstructive defects, 55% in those with restrictive defects, and 42.6% in those with mixed airflow defects. The unadjusted HRs for mortality were 2.64 (95% CI 2.10-3.32) for the overall cohort, 2.24 (95% CI 1.48-3.40) for obstructive defects, 2.45 (95% CI 1.12-5.36) for restrictive defects, and 2.79 (95% CI 1.41-3.17) for mixed airflow defects. After adjusting for age and sex, the HRs remained statistically significant: 2.25 (95% CI 1.37-2.84) for the overall cohort, 2.08 (95% CI 1.37-3.18) for obstructive defects, 2.27 (95% CI 1.04-1.17) for restrictive defects, and 2.21 (95% CI 1.20-3.08) for mixed airflow defects.
Frailty is a common syndrome and is associated with a significantly increased risk of mortality. The FI provides valuable information for risk profiling and personalized interventions beyond age and lung function parameters. Including frailty assessment in clinical evaluations can aid in resource allocation and improve patient care in respiratory diseases.
衰弱与不良健康结局的易感性增加和对医疗干预的耐受性降低有关。其对慢性呼吸系统疾病患者的影响，尤其是在慢性阻塞性肺疾病（COPD）之外，仍知之甚少。
评估不同“肺量计”模式下衰弱指数与 5 年死亡率之间的关联，并评估其衰弱决定因素的变化。
本研究分析了 SARA 研究的数据，该研究纳入了 1968 名老年人，以评估不同肺量计模式下衰弱与 5 年死亡率之间的关联。使用衰弱指数（FI）评估衰弱，进行肺功能模式测定。使用 Cox 回归模型计算风险比（HRs），并调整年龄和性别因素。
在研究参与者中，16%被归类为衰弱。衰弱与所有肺量计模式下的死亡率显著增加相关。在正常肺量计的受试者中，5 年死亡率为 34.3%，在阻塞性缺陷的受试者中为 45.1%，在限制性缺陷的受试者中为 55%，在混合气流缺陷的受试者中为 42.6%。总体队列的未调整死亡率 HR 为 2.64（95%CI 2.10-3.32），阻塞性缺陷为 2.24（95%CI 1.48-3.40），限制性缺陷为 2.45（95%CI 1.12-5.36），混合气流缺陷为 2.79（95%CI 1.41-3.17）。调整年龄和性别后，HR 仍具有统计学意义：总体队列为 2.25（95%CI 1.37-2.84），阻塞性缺陷为 2.08（95%CI 1.37-3.18），限制性缺陷为 2.27（95%CI 1.04-1.17），混合气流缺陷为 2.21（95%CI 1.20-3.08）。
衰弱是一种常见的综合征，与死亡率显著增加相关。FI 提供了有价值的信息，可用于风险分析和年龄及肺功能参数之外的个性化干预。在临床评估中纳入衰弱评估可以帮助分配资源并改善呼吸系统疾病患者的护理。
