Aix Marseille Univ, CNRS, EFS, ADES, Bat A - CS 80011, 51 Boulevard Pierre Dramard, 13344 Marseille cedex 15, France; Aix Marseille Univ, Faculté des Sciences Médicales et Paramédicales, Ecole des Sciences Infirmières, 51 Boulevard Pierre Dramard, 13344 Marseille cedex 15, France; Assistance Publique des Hôpitaux de Marseille (APHM), Coordination Générale des Soins, 80 Rue Brochier, 13354 Marseille cedex 5, France.
Aix Marseille Univ, CNRS, EFS, ADES, Bat A - CS 80011, 51 Boulevard Pierre Dramard, 13344 Marseille cedex 15, France; Assistance Publique des Hôpitaux de Marseille (APHM), Médecine Interne, Gériatrie et Thérapeutique, 270 Boulevard de Sainte Marguerite, 13274 Marseille cedex 9, France.
J Epidemiol Popul Health. 2024 Oct;72(5):202774. doi: 10.1016/j.jeph.2024.202774. Epub 2024 Oct 7.
Frailty and hospital readmissions are two major problems for older people because of their impact on health, quality of life and healthcare systems. The aims of this study were to investigate the relationship between frailty and unplanned readmissions at 30, 90, 180 days and 1 year in hospitalised older people, and to identify the most relevant tools for assessing readmission risk in different clinical settings to facilitate systematic identification of this high-risk population by healthcare professionals.
This review was based on a systematic search of the MEDLINE, EMBASE and SCIENCEDIRECT databases for articles published between January 2011 and December 2021 that examined the association between frailty and unplanned readmission in hospitalised adults aged 65 years and over using identified validated tools.
44 eligible studies out of 1362 were included in a descriptive analysis. Sixteen countries were represented with older adults hospitalised in medical, surgical, post-acute care and rehabilitation, and emergency departments. Up to 84.5% of frail older adults had an unplanned readmission. Of the 21 tools identified, the Hospital Frailty Risk Score (HFRS), the Frailty Index (FI), its derivatives, the Clinical Frailty Scale (CFS) and the Fried model were the most widely used and relevant tools for identifying the association between frailty and unplanned readmission.
Frailty is widely associated with readmission risk in older adults. The HFRS, FI, CFS and Fried model appear to be the most commonly used tools to assess frailty and prevent unplanned readmissions.
衰弱和医院再入院是老年人面临的两个主要问题，因为它们会对健康、生活质量和医疗系统产生影响。本研究旨在调查衰弱与住院老年人在 30、90、180 天和 1 年时计划外再入院之间的关系，并确定在不同临床环境下评估再入院风险的最相关工具，以方便医疗保健专业人员系统地识别这一高风险人群。
本综述基于对 MEDLINE、EMBASE 和 SCIENCEDIRECT 数据库中 2011 年 1 月至 2021 年 12 月期间发表的文章进行系统检索，这些文章使用已确定的验证工具，调查了 65 岁及以上住院成人衰弱与计划外再入院之间的关联。
在描述性分析中，从 1362 篇文章中纳入了 44 篇符合条件的研究。这些研究代表了 16 个国家，研究对象为在医疗、外科、康复和急症部门住院的老年人。高达 84.5%的衰弱老年人发生了计划外再入院。在所确定的 21 种工具中，医院衰弱风险评分（HFRS）、衰弱指数（FI）、其衍生工具、临床衰弱量表（CFS）和 Fried 模型是最广泛使用和与识别衰弱与计划外再入院之间关联的相关工具。
衰弱与老年人的再入院风险广泛相关。HFRS、FI、CFS 和 Fried 模型似乎是评估衰弱和预防计划外再入院最常用的工具。
