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脆弱风险对动脉瘤性蛛网膜下腔出血后功能结局的影响:一项历史性队列研究。

Impact of Frailty Risk on Functional Outcome after Aneurysmal Subarachnoid Hemorrhage: A Historical Cohort Study.

机构信息

Department of Rehabilitation Medicine, Mie University Graduate School of Medicine.

Department of Rehabilitation, Mie University Hospital.

出版信息

Neurol Med Chir (Tokyo). 2024 Nov 15;64(11):409-417. doi: 10.2176/jns-nmc.2023-0251. Epub 2024 Sep 26.

DOI:10.2176/jns-nmc.2023-0251
PMID:39322547
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11617354/
Abstract

We evaluated the utility of the Hospital Frailty Risk Score (HFRS) as a predictor of adverse events post-hospitalization in a retrospective analysis of patients undergoing neurosurgical procedures due to aneurysmal subarachnoid hemorrhage (SAH). This historical cohort study analyzed the data of patients hospitalized with aneurysmal SAH (n = 1,343) between April 2014 and August 2020 who were registered in the JMDC database. We used HFRS to classify the patients into the low-frailty risk group (HFRS < 5) and high-frailty risk group (HFRS ≥ 5). The primary outcome was a modified Rankin Scale (mRS) score of 0-2 points at discharge. Of 1,343 patients, 1,001 (74.5%) and 342 (25.5%) were in the low- and high-frailty risk groups, respectively. A high-frailty risk was negatively associated with a mRS score of 0-2 at discharge (high-frailty risk group: odds ratio 0.4; 95% confidence interval [CI]: 0.3-0.6) and home discharge (high-frailty risk group: odds ratio 0.5; 95% CI: 0.4-0.7). A high-frailty risk was negatively associated with Barthel Index gain (high-frailty risk group: coefficient -10.4, 95% CI: -14.7 to -6.2) and had a longer length of stay (high-frailty risk group: coefficient 8.4, 95% CI: 5.1-11.7). HFRS could predict adverse outcomes during hospitalization of aneurysmal SAH patients.

摘要

我们评估了医院衰弱风险评分(HFRS)作为预测因颅内动脉瘤性蛛网膜下腔出血(SAH)接受神经外科手术患者出院后不良事件的指标。这项回顾性分析纳入了 2014 年 4 月至 2020 年 8 月期间在 JMDC 数据库中登记的因颅内动脉瘤性 SAH 住院的 1343 例患者的数据。我们使用 HFRS 将患者分为低衰弱风险组(HFRS<5)和高衰弱风险组(HFRS≥5)。主要结局为出院时改良 Rankin 量表(mRS)评分 0-2 分。在 1343 例患者中,1001 例(74.5%)和 342 例(25.5%)分别为低衰弱风险组和高衰弱风险组。高衰弱风险与出院时 mRS 评分 0-2 分呈负相关(高衰弱风险组:比值比 0.4;95%置信区间[CI]:0.3-0.6)和出院回家呈负相关(高衰弱风险组:比值比 0.5;95%CI:0.4-0.7)。高衰弱风险与 Barthel 指数增加呈负相关(高衰弱风险组:系数-10.4,95%CI:-14.7 至-6.2),住院时间延长(高衰弱风险组:系数 8.4,95%CI:5.1-11.7)。HFRS 可预测颅内动脉瘤性 SAH 患者住院期间的不良结局。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7b6e/11617354/fdb22ce6f6a2/1349-8029-64-11-0409-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7b6e/11617354/fdb22ce6f6a2/1349-8029-64-11-0409-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7b6e/11617354/fdb22ce6f6a2/1349-8029-64-11-0409-g001.jpg

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