Thompson Mark Q, Fatema Nur-E-Zannat, Tucker Graeme R, Khalid Ashna, Huang Yue, Smyth Carla R, Yu Solomon, Visvanathan Renuka
Adelaide Geriatrics Training and Research with Aged Care (GTRAC) Centre, Faculty of Health and Medical Sciences, Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia.
Basil Hetzel Institute, Central Adelaide Local Health Network, Adelaide, South Australia, Australia.
Australas J Ageing. 2025 Mar;44(1):e13374. doi: 10.1111/ajag.13374. Epub 2024 Oct 8.
Frailty is in an increasing focus for acute care systems due to its association with adverse health outcomes. The Clinical Frailty Scale (CFS) is a judgement-based frailty assessment tool, which classifies the frailty status of older adults, but more research involving general medicine inpatients is necessary. The objectives of this study were to describe the predictive ability of CFS, administered by geriatric medicine trained nurses, for adverse outcomes including the following: acute unit and total length of stay (LOS), new nursing home (NH) admission, 12-month mortality and readmission within 30-day.
Design Retrospective study. Participants Patients admitted under general medicine unit and seen by the geriatric medicine liaison team in one general hospital. Main Measure CFS.
Of 394 patients included, 60% were mild-moderately frail, and 21% severely frail. In a multivariable analysis, patients classified as severely frail (CFS 7-9) had significantly high odds of death during admission (OR = 13.64), new NH admission (OR = 34.97) and acute LOS (OR = 1.74), compared to non-frail patients (CFS1-4). Mild-moderately frail (CFS 5-6) patients had significantly higher odds for new NH admission (OR = 4.36), acute unit LOS (OR = 1.49) and total LOS (OR = 1.61) compared to non-frail patients. In a Cox regression multivariable survival analysis, the severely frail had a sixfold significantly higher likelihood (HR = 6.19) of 12-month mortality, and the mild-moderately frail had a doubled likelihood (HR = 2.13), compared to the non-frail.
The CFS has clinical utility for identifying general medicine older inpatients at-risk of various adverse outcomes.
由于衰弱与不良健康结局相关，其在急性护理系统中受到越来越多的关注。临床衰弱量表（CFS）是一种基于判断的衰弱评估工具，用于对老年人的衰弱状况进行分类，但需要更多涉及普通内科住院患者的研究。本研究的目的是描述由接受老年医学培训的护士管理的CFS对不良结局的预测能力，这些不良结局包括：急性病房和总住院时间（LOS）、新入住养老院（NH）、12个月死亡率和30天内再入院。
设计回顾性研究。参与者为在一家综合医院普通内科病房住院并由老年医学联络团队诊治的患者。主要测量指标为CFS。
在纳入的394例患者中，60%为轻度至中度衰弱，21%为重度衰弱。在多变量分析中，与非衰弱患者（CFS 1-4）相比，被分类为重度衰弱（CFS 7-9）的患者在住院期间死亡（OR = 13.64）、新入住NH（OR = 34.97）和急性住院时间（OR = 1.74）的几率显著更高。与非衰弱患者相比，轻度至中度衰弱（CFS 5-6）患者新入住NH（OR = 4.36）、急性病房住院时间（OR = 1.49）和总住院时间（OR = 1.61）的几率显著更高。在Cox回归多变量生存分析中，与非衰弱患者相比，重度衰弱患者12个月死亡率的可能性显著高出六倍（HR = 6.19），轻度至中度衰弱患者的可能性高出一倍（HR = 2.13）。
CFS在识别有各种不良结局风险的普通内科老年住院患者方面具有临床实用性。
