Ji Hyunju, Lee Jae Jun, Lee Kyung Hee
Severance Hospital, Yonsei University Health System, Seoul, Republic of Korea.
Yonsei University College of Nursing and Mo-Im Kim Nursing Research Institute, Seoul, Republic of Korea.
Nurs Crit Care. 2025 May;30(3):e13222. doi: 10.1111/nicc.13222. Epub 2025 Jan 6.
Although frailty assessment is crucial for understanding critically ill patients' prognosis, traditional frailty measures require substantial efforts and time from health care professionals. To address this limitation, the laboratory frailty index (FI-LAB) based on laboratory clinical data was developed. However, knowledge regarding its correlation with health outcomes among critically ill older patients is limited.
To identify the association between the FI-LAB and acute, mid- and long-term outcomes among critically ill older adults.
This retrospective correlational study used electronic health records of 2106 older patients who were admitted to the intensive care unit at a tertiary hospital in Seoul, Korea. Acute and mid-term outcomes included occurrence of delirium and in-hospital mortality, and the long-term outcome included 1-year mortality. Logistic regression was used to explore the relationships across FI-LAB, delirium, and in-hospital mortality, while Cox proportional hazard regression was used to analyse the relationship between FI-LAB and 1-year mortality.
Frailty assessed by FI-LAB was significantly associated with increased risk of delirium (odds ratio [OR] = 6.21, 95% confidence interval [CI] = 2.31-25.39, p = .009), in-hospital mortality (OR = 2.38, 95% CI = 1.15-5.79, p = .014), and 1-year mortality (hazard ratio = 2.47, 95% CI = 1.16-5.25, p = .019) after controlling for covariates.
The study highlighted the importance of using FI-LAB for screening frailty in critically ill older adults. Health care providers can improve patients' acute, mid- and long-term outcomes to develop more individualised management plans based on FI-LAB scores.
The FI-LAB score calculated from routine laboratory data can be used by nurses as a screening tool to identify frail older adults in critical care. Early detection of frailty would allow for closer monitoring and the implementation of interventions to reduce delirium and mortality.
尽管衰弱评估对于了解重症患者的预后至关重要，但传统的衰弱测量方法需要医护人员投入大量精力和时间。为解决这一局限性，基于实验室临床数据开发了实验室衰弱指数（FI-LAB）。然而，关于其与重症老年患者健康结局的相关性的知识有限。
确定FI-LAB与重症老年患者急性、中期和长期结局之间的关联。
这项回顾性相关性研究使用了韩国首尔一家三级医院重症监护病房收治的2106例老年患者的电子健康记录。急性和中期结局包括谵妄的发生和住院死亡率，长期结局包括1年死亡率。采用逻辑回归分析FI-LAB、谵妄和住院死亡率之间的关系，同时采用Cox比例风险回归分析FI-LAB与1年死亡率之间的关系。
在控制协变量后，通过FI-LAB评估的衰弱与谵妄风险增加（比值比[OR]=6.21，95%置信区间[CI]=2.31-25.39，p=0.009）、住院死亡率（OR=2.38，95%CI=1.15-5.79，p=0.014）和1年死亡率（风险比=2.47，95%CI=1.16-5.25，p=0.019）显著相关。
该研究强调了使用FI-LAB筛查重症老年患者衰弱的重要性。医护人员可以根据FI-LAB评分制定更个性化的管理计划，从而改善患者的急性、中期和长期结局。
护士可将根据常规实验室数据计算出的FI-LAB评分用作筛查工具，以识别重症监护中的衰弱老年患者。早期发现衰弱将有助于进行更密切的监测并实施干预措施，以减少谵妄和死亡率。
