临床衰弱量表与成人COVID-19患者住院24个月后死亡率之间的关联
Association between Clinical Frailty Scale and mortality 24 months after hospitalisation in adult patients with COVID-19.
作者信息
Minnema Julia, Lafeber Melvin, Sablerolles Roos S G, van Kempen Janneke A L, Tap Lisanne, Polinder-Bos Harmke A, van de Loo Bob P A, van der Kuy Hugo, Faes Miriam C
机构信息
Department of Internal Medicine, Erasmus MC, University Medical Centre Rotterdam, the Netherlands.
Department of Hospital Pharmacy, Erasmus MC, University Medical Centre Rotterdam, the Netherlands.
出版信息
Heliyon. 2024 Nov 15;10(23):e40456. doi: 10.1016/j.heliyon.2024.e40456. eCollection 2024 Dec 15.
BACKGROUND
The clinical frailty scale (CFS) was used as a triage tool for medical decision making during the COVID-19 pandemic. The CFS has been posed as a suitable risk marker for in-hospital mortality in COVID-19 patients. We evaluated whether the CFS is associated with mortality 24 months after hospitalisation for COVID-19.
METHODS
The COvid MEdicaTion (COMET) study is an international, multicentre, observational cohort study, including adult patients hospitalised for COVID-19 between March 2020-July 2020. Patients' characteristics, prescribed medication, clinical characteristics, and CFS were collected at admission, survival data were collected 24 months after hospitalisation. Multivariable cox proportional hazard models stratified by age (<65 and ≥65 years), and adjusted for covariates (age, sex, number of drugs, and types of drug class as a proxy for comorbidities) were used to study the association between the CFS and 24-month mortality after hospitalisation.
RESULTS
In this study, 1238 fit (CFS 1-3), 478 mildly frail (CFS 4-5), and 235 frail (CFS 6-9) patients were included for baseline analysis (median age 68 years (IQR 58-78); 58.5 % male). Frailty was associated with an increased risk of 24-month mortality after hospitalisation in older patients (HR 1.91, 95 % CI [1.17-3.12]), in younger adults a trend was seen (HR 3.13, 95 % CI [0.86-11.36]).
CONCLUSION
The results suggest that the CFS is an indicator for mortality 24 months after hospitalisation in COVID-19 patients.
背景
临床衰弱量表（CFS）在新冠疫情期间被用作医疗决策的分诊工具。CFS被认为是新冠患者院内死亡的合适风险标志物。我们评估了CFS是否与新冠住院24个月后的死亡率相关。
方法
新冠药物治疗（COMET）研究是一项国际多中心观察性队列研究，纳入了2020年3月至2020年7月期间因新冠住院的成年患者。入院时收集患者的特征、处方药物、临床特征和CFS，住院24个月后收集生存数据。采用按年龄（<65岁和≥65岁）分层并针对协变量（年龄、性别、药物数量和作为合并症替代指标的药物类别类型）进行调整的多变量Cox比例风险模型，研究CFS与住院24个月后死亡率之间的关联。
结果
本研究纳入了1238例健康（CFS 1 - 3）、478例轻度衰弱（CFS 4 - 5）和235例衰弱（CFS 6 - 9）患者进行基线分析（中位年龄68岁（IQR 58 - 78）；58.5%为男性）。在老年患者中，衰弱与住院24个月后死亡风险增加相关（HR 1.91，95% CI [1.17 - 3.12]），在年轻成年人中也有此趋势（HR 3.13，95% CI [0.86 - 11.36]）。
结论
结果表明，CFS是新冠患者住院24个月后死亡率的一个指标。
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