Ni Chunhua, Gu Chen, Liu Hua, Cheng Feng, Cheng Chao, Xia Xiaohua
Intensive Care Unit, Kunshan Hospital Affiliated to Jiangsu University, Qianjin East Road, China.
Neurosurgery Department, Kunshan Hospital Affiliated to Jiangsu University, Qianjin East Road, China.
Clinics (Sao Paulo). 2025 Jan 25;80:100554. doi: 10.1016/j.clinsp.2024.100554. eCollection 2025.
Mild Traumatic Brain Injury (mTBI) is quite prevalent in the elderly population, and the authors performed a retrospective analysis regarding the predictive value of frailty assessing tools regarding the prognosis of elderly mTBI patients.
All the patients underwent assessment of frailty upon admission using five tools including Frailty Phenotype (FP), FRAIL Scale (FS), Edmonton Frailty Scale (EFS), Groningen Frailty Indicator (GFI), and Clinical Frailty Scale (CFS). The predicting potential of tools was analyzed against the prognosis defined by the extended Glasgow Outcome Scale (GOSE).
The incidence of frailty in elderly patients varies widely among the tools. Multivariate logistic regression analysis showed that only frail conditions defined by FP (p-value = 0.014) and FS (p-value = 0.004) could be employed for predicting unfavorable prognosis defined by GOSE, while frailty defined by CFS (p-value = 0.683), EFS (p-value = 0.301) and GFI (p-value = 0.925) could not. The ROC further showed that FP (AUC = 73.2 %) and FS (AUC = 76.2 %) had moderate power in predicting unfavorable conditions, while CFS (AUC = 46.1 %), EFS (AUC = 55.6 %), and GFI (AUC = 51.5 %) only had low or even no power.
FP and FS could be used to predict the unfavorable prognosis associated with mTBI in the elderly population.
轻度创伤性脑损伤（mTBI）在老年人群中相当普遍，作者对衰弱评估工具对老年mTBI患者预后的预测价值进行了回顾性分析。
所有患者入院时使用五种工具进行衰弱评估，包括衰弱表型（FP）、衰弱量表（FS）、埃德蒙顿衰弱量表（EFS）、格罗宁根衰弱指标（GFI）和临床衰弱量表（CFS）。根据扩展格拉斯哥预后量表（GOSE）定义的预后分析这些工具的预测潜力。
各工具评估的老年患者衰弱发生率差异很大。多因素逻辑回归分析显示，只有FP（p值 = 0.014）和FS（p值 = 0.004）定义的衰弱状态可用于预测GOSE定义的不良预后，而CFS（p值 = 0.683）、EFS（p值 = 0.301）和GFI（p值 = 0.925）定义的衰弱状态则不能。ROC曲线进一步显示，FP（AUC = 73.2%）和FS（AUC = 76.2%）在预测不良状况方面具有中等效力，而CFS（AUC = 46.1%）、EFS（AUC = 55.6%）和GFI（AUC = 51.5%）仅具有低效力甚至无效力。
FP和FS可用于预测老年人群中与mTBI相关的不良预后。
