Zaboli Arian, Brigo Francesco, Sibilio Serena, Brigiari Gloria, Massar Magdalena, Magnarelli Gabriele, Parodi Marta, Mian Michael, Pfeifer Norbert, Turcato Gianni
Innovation, Research and Teaching Service (SABES-ASDAA), Teaching Hospital of the Paracelsus Medical Private University (PMU), Via A. Volta, 13°, Bolzano, Italy.
Department Public Health, Institute of Nursing Science, Universitat Basel, Basel, BS, Switzerland.
Intern Emerg Med. 2025 Mar;20(2):563-571. doi: 10.1007/s11739-024-03684-7. Epub 2024 Jun 20.
Currently, there is conflicting evidence regarding the efficacy of frailty scales and their ability to enhance or support triage operations. This study aimed to assess the utility of three common frailty scales (CFS, PRISMA-7, ISAR) and determine their utility in the triage setting. This prospective observational monocentric study was conducted at Merano Hospital's Emergency Department (ED) from June 1st to December 31st, 2023. All patients attending this ED during the 80-day study period were included, and frailty scores were correlated with three outcomes: hospitalization, 30-day mortality, and severity of condition as assessed by ED physicians. Patients were categorized by age, and analyses were performed for the entire study population, patients aged 18-64, and those aged 65 or older. Univariate analysis was followed by multivariable analysis to evaluate whether frailty scores were independently associated with the outcomes. In multivariable analysis, none of the frailty scores were found to be associated with the study outcomes, except for the CFS, which was associated with an increased risk of 30-day mortality, with an odds ratio of 1.752 (95% CI 1.148-2.674; p = 0.009) in the general population and 1.708 (95% CI 1.044-2.793; p = 0.033) in the population aged ≥ 65. Presently, available frailty scores do not appear to be useful in the triage context. Future research should consider developing new systems for accurate frailty assessment to support risk prediction in the triage assessment.
目前，关于衰弱量表的有效性及其增强或支持分诊操作的能力，存在相互矛盾的证据。本研究旨在评估三种常见衰弱量表（CFS、PRISMA-7、ISAR）的效用，并确定它们在分诊环境中的实用性。这项前瞻性观察性单中心研究于2023年6月1日至12月31日在梅拉诺医院急诊科进行。纳入了在80天研究期间到该急诊科就诊的所有患者，并将衰弱评分与三个结果相关联：住院、30天死亡率以及急诊科医生评估的病情严重程度。患者按年龄分类，并对整个研究人群、18至64岁的患者以及65岁及以上的患者进行了分析。先进行单变量分析，然后进行多变量分析，以评估衰弱评分是否与这些结果独立相关。在多变量分析中，除CFS外，没有发现任何衰弱评分与研究结果相关，CFS与30天死亡率增加的风险相关，在一般人群中的比值比为1.752（95%CI 1.148-2.674；p = 0.009），在65岁及以上人群中的比值比为1.708（95%CI 1.044-2.793；p = 0.033）。目前，现有的衰弱评分在分诊背景下似乎没有用处。未来的研究应考虑开发新的系统，以进行准确的衰弱评估，以支持分诊评估中的风险预测。
