Topcu Yildiray, Gobbens Robbert J J, van der Ploeg Tjeerd, Tufan Fatih
Prof. Dr. Cemil Taşcıoğlu Şehir Hastanesi, Istanbul, Turkiye.
Faculty of Health, Sports and Social Work, Inholland University of Applied Sciences, Amsterdam, the Netherlands.
Int J Gen Med. 2024 Dec 8;17:5883-5895. doi: 10.2147/IJGM.S485675. eCollection 2024.
To our knowledge, there have been no comparative studies evaluating the associations of frailty defined using the Tilburg Frailty Indicator (TFI), frailty phenotype by Fried et al, and FRAIL scale with all-cause mortality in Turkiye. In this study, we aimed to evaluate the ability of these instruments in predicting all-cause mortality in outpatients admitted to the outpatient geriatrics clinic of a university hospital.
This historical prospective study was performed in the geriatrics outpatient clinic of a university hospital in Istanbul, Turkiye. Consecutive older adults (aged ≥ 70 years) who provided written informed consent were enrolled in the study. The survival status of participants was checked electronically using the official death registry system. Univariate analyses and multivariate Cox regression analyses were performed to determine the independent predictors of mortality.
A total of 198 participants with a median age of 77 years were enrolled. During the median follow-up period of 2236 days, 54 (27.3%) patients died. In univariate analyses, male sex, history of falls in the previous year, dependency in instrumental activities of daily living, malnutrition, and frailty with respect to the phenotype by Fried et al, FRAIL scale, and TFI were associated with mortality. In multivariate Cox regression analyses, frailty according to each of the three frailty instruments, male sex, older age, history of falls, and malnutrition or malnutrition risk were independently associated with mortality. The Fried scale was the best frailty tool among the three frailty instruments used to predict all-cause mortality.
The findings of this study suggest that frailty, determined using each of the three instruments used in the present study, is independently associated with all-cause mortality in patients admitted to the outpatient geriatrics clinic of a university hospital in Turkiye. The Fried scale appears to be the best for predicting all-cause mortality.
据我们所知，在土耳其，尚未有比较研究评估使用蒂尔堡衰弱指标（TFI）定义的衰弱、弗里德等人提出的衰弱表型以及衰弱量表与全因死亡率之间的关联。在本研究中，我们旨在评估这些工具预测大学医院门诊老年病科门诊患者全因死亡率的能力。
本历史前瞻性研究在土耳其伊斯坦布尔一家大学医院的老年病门诊进行。纳入连续的年龄≥70岁且提供书面知情同意书的老年人。使用官方死亡登记系统以电子方式检查参与者的生存状态。进行单因素分析和多因素Cox回归分析以确定死亡率的独立预测因素。
共纳入198名参与者，中位年龄为77岁。在中位随访期2236天内，54名（27.3%）患者死亡。在单因素分析中，男性、前一年有跌倒史、在工具性日常生活活动方面存在依赖、营养不良以及根据弗里德等人的表型、衰弱量表和TFI定义的衰弱与死亡率相关。在多因素Cox回归分析中，根据三种衰弱工具中的每一种定义的衰弱、男性、年龄较大、跌倒史以及营养不良或营养不良风险与死亡率独立相关。在用于预测全因死亡率的三种衰弱工具中，弗里德量表是最佳的衰弱工具。
本研究结果表明，使用本研究中使用的三种工具中的每一种确定的衰弱与土耳其一家大学医院门诊老年病科门诊患者的全因死亡率独立相关。弗里德量表似乎最适合预测全因死亡率。
