Asscher Vera E R, Rodriguez Gírondo Mar, Fens Jesse, Waars Sanne N, Stuyt Rogier J L, Baven-Pronk A Martine C, Srivastava Nidhi, Jacobs Rutger J, Haans Jeoffrey J L, Meijer Lennart J, Klijnsma-Slagboom Jacqueline D, Duin Marijn H, Peters Milou E R, Lee-Kong Felicia V Y L, Provoost Nanda E, Tijdeman Femke, van Dijk Kenan T, Wieland Monse W M, Verstegen Mirre G M, van der Meijs Melissa E, Maan Annemijn D I, van Deudekom Floor J, van der Meulen-de Jong Andrea E, Mooijaart Simon P, Maljaars P W Jeroen
Department of Gastroenterology and Hepatology, Leiden University Medical Centre, Leiden, the Netherlands.
Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, the Netherlands.
J Crohns Colitis. 2024 Apr 23;18(4):516-524. doi: 10.1093/ecco-jcc/jjad175.
Our goals were to study frailty screening in association with hospitalization and decline in quality of life [QoL] and functional status in older patients with inflammatory bowel diseases [IBD].
This was a prospective multicentre cohort study in IBD patients ≥65 years old using frailty screening [G8 Questionnaire]. Outcomes were all-cause, acute, and IBD-related hospitalization, any infection, any malignancy, QoL [EQ5D-3L], and functional decline (Instrumental Activities of Daily Living [IADL]) during 18 months of follow-up. Confounders were age, IBD type, biochemical disease activity [C-reactive protein ≥10 mg/L and/or faecal calprotectin ≥250 µg/g], and comorbidity [Charlson Comorbidity Index].
Of 405 patients, with a median age of 70 years, 196 [48%] were screened as being at risk for frailty. All-cause hospitalizations occurred 136 times in 96 patients [23.7%], and acute hospitalizations 103 times in 74 patients [18.3%]. Risk of frailty was not associated with all-cause (adjusted hazard ratio [aHR] 1.5, 95% confidence interval [CI] 0.9-2.4), but was associated with acute hospitalizations [aHR 2.2, 95% CI 1.3-3.8]. Infections occurred in 86 patients [21.2%] and these were not associated with frailty. A decline in QoL was experienced by 108 [30.6%] patients, and a decline in functional status by 46 patients [13.3%]. Frailty screening was associated with a decline in QoL (adjusted odds ratio [aOR] 2.1, 95% CI 1.3-3.6) and functional status [aOR 3.7, 95% CI 1.7-8.1].
Frailty screening is associated with worse health outcomes in older patients with IBD. Further studies are needed to assess the feasibility and effectiveness of its implementation in routine care.
我们的目标是研究老年炎症性肠病（IBD）患者中衰弱筛查与住院情况以及生活质量（QoL）和功能状态下降之间的关系。
这是一项针对年龄≥65岁的IBD患者的前瞻性多中心队列研究，采用衰弱筛查（G8问卷）。观察指标包括全因、急性和IBD相关住院情况、任何感染、任何恶性肿瘤、生活质量（EQ5D - 3L）以及随访18个月期间的功能下降情况（工具性日常生活活动[IADL]）。混杂因素包括年龄、IBD类型、生化疾病活动度（C反应蛋白≥10mg/L和/或粪便钙卫蛋白≥250μg/g）以及合并症（Charlson合并症指数）。
405例患者的中位年龄为70岁，其中196例（48%）被筛查为有衰弱风险。96例患者（23.7%）发生全因住院136次，74例患者（18.3%）发生急性住院103次。衰弱风险与全因住院无关（调整后风险比[aHR]为1.5，95%置信区间[CI]为0.9 - 2.4），但与急性住院相关[aHR 2.2，95% CI 1.3 - 3.8]。86例患者（21.2%）发生感染，且感染与衰弱无关。108例患者（30.6%）经历了生活质量下降，46例患者（13.3%）出现功能状态下降。衰弱筛查与生活质量下降（调整后优势比[aOR]为2.1，95% CI为1.3 - 3.6）和功能状态下降[aOR 3.7，95% CI为1.7 - 8.1]相关。
衰弱筛查与老年IBD患者较差的健康结局相关。需要进一步研究以评估在常规护理中实施衰弱筛查的可行性和有效性。
