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医院衰弱风险评分可预测2010年至2018年美国数据中住院肾移植受者的移植失败、严重感染和死亡率。

Hospital frailty risk score predicts graft failure severe infection and mortality in hospitalized kidney transplant recipients from 2010 to 2018 US data.

作者信息

Chen Lumin, Chu Feifan, Ma Hangbin, Chen Zujie, Ma Yuning, Ji Qiwei, Zhou Hao

机构信息

Department of Urology, The Fourth Affiliated Hospital of School of Medicine, International School of Medicine, International Institutes of Medicine, Zhejiang University, Yiwu, 322000, China.

出版信息

Sci Rep. 2025 Feb 7;15(1):4604. doi: 10.1038/s41598-025-85482-5.

DOI:10.1038/s41598-025-85482-5
PMID:39920192
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11805901/
Abstract

Frailty is frequently assessed in elderly patients as an indicator of poor outcomes after hospitalization and surgery. Compared to age-matched nonfrail people, frail people need greater assistance with everyday activities and are more likely to suffer adverse events leading to mortality. Recently, the hospital frailty risk score (HFRS) was proposed for quantifying frailty. The number of older people with end-stage renal disease (ESRD) is continuing to increase, and more data have shown that frailty could predict adverse outcomes in kidney transplantation (KT) patients. Moreover, the pre-kidney transplantation HFRS was strongly associated with surgical complications and other adverse and postoperative outcomes. However, it is yet unknown how frailty affects transplant failure prognosis, inpatient mortality and morbidity, and infection. In this retrospective observational study, we extracted data on 185,742 patients from the National Inpatient Sample (NIS) database in the United States. The patients were further separated into three groups based on the HFRS. The study revealed that 24.6% of admitted patients who underwent KT were frail (HFRS > = 5). HFRS stratification can be used to predict the risk of in-hospital mortality, longer LOS, graft failure, and adverse discharge. Furthermore, frail patients who undergo KT are more likely to develop severe infection according to the HFRS-defined frailty classification. According to these findings, frailty remains a severe problem after KT, and patients who undergo KT should be monitored to prevent adverse effects.

摘要

衰弱在老年患者中经常被评估,作为住院和手术后不良预后的一个指标。与年龄匹配的非衰弱人群相比,衰弱人群在日常活动中需要更多帮助,并且更有可能遭受导致死亡的不良事件。最近,提出了医院衰弱风险评分(HFRS)来量化衰弱。终末期肾病(ESRD)老年患者的数量持续增加,更多数据表明衰弱可以预测肾移植(KT)患者的不良预后。此外,肾移植前的HFRS与手术并发症以及其他不良和术后结果密切相关。然而,衰弱如何影响移植失败预后、住院死亡率和发病率以及感染尚不清楚。在这项回顾性观察研究中,我们从美国国家住院样本(NIS)数据库中提取了185742例患者的数据。根据HFRS将患者进一步分为三组。研究显示,接受KT的入院患者中有24.6%是衰弱的(HFRS≥5)。HFRS分层可用于预测住院死亡率、更长的住院时间、移植失败和不良出院的风险。此外,根据HFRS定义的衰弱分类,接受KT的衰弱患者更有可能发生严重感染。根据这些发现,衰弱在KT后仍然是一个严重问题,应对接受KT的患者进行监测以预防不良影响。

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Hospital frailty risk score predicts graft failure severe infection and mortality in hospitalized kidney transplant recipients from 2010 to 2018 US data.医院衰弱风险评分可预测2010年至2018年美国数据中住院肾移植受者的移植失败、严重感染和死亡率。
Sci Rep. 2025 Feb 7;15(1):4604. doi: 10.1038/s41598-025-85482-5.
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本文引用的文献

1
Transitions in frailty state 12 months after kidney transplantation: a prospective cohort study.移植后 12 个月虚弱状态的转变:一项前瞻性队列研究。
J Nephrol. 2022 Dec;35(9):2341-2349. doi: 10.1007/s40620-022-01436-4. Epub 2022 Sep 1.
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Outcomes of Frail Patients While Waiting for Kidney Transplantation: Differences between Physical Frailty Phenotype and FRAIL Scale.等待肾移植的虚弱患者的结局:身体虚弱表型与衰弱量表之间的差异
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External validation of the Hospital Frailty Risk Score in France.法国的医院衰弱风险评分的外部验证。
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Utility of the Hospital Frailty Risk Score Derived From Administrative Data and the Association With Stroke Outcomes.源自行政数据的医院虚弱风险评分的效用及其与卒中结局的关联。
Stroke. 2021 Aug;52(9):2874-2881. doi: 10.1161/STROKEAHA.120.033648. Epub 2021 Jun 17.
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Prevalence and Associated Factors of Frailty and Mortality in Patients with End-Stage Renal Disease Undergoing Hemodialysis: A Systematic Review and Meta-Analysis.接受血液透析的终末期肾病患者衰弱和死亡的患病率及相关因素:一项系统评价和荟萃分析
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Frailty predicts surgical complications after kidney transplantation. A propensity score matched study.虚弱预测肾移植后的手术并发症。一项倾向评分匹配研究。
PLoS One. 2020 Feb 26;15(2):e0229531. doi: 10.1371/journal.pone.0229531. eCollection 2020.
8
The Causes of Kidney Allograft Failure: More Than Alloimmunity. A Viewpoint Article.肾移植失败的原因:不仅仅是同种异体免疫。观点文章。
Transplantation. 2020 Feb;104(2):e46-e56. doi: 10.1097/TP.0000000000003012.
9
The Frailty Risk Score predicts length of stay and need for rehospitalization after kidney transplantation in a retrospective cohort: a pilot study.虚弱风险评分在一项回顾性队列研究中预测肾移植后的住院时间和再次住院需求:一项试点研究。
Pilot Feasibility Stud. 2019 Dec 10;5:144. doi: 10.1186/s40814-019-0534-2. eCollection 2019.
10
Prevalence of frailty among kidney transplant candidates and recipients in the United States: Estimates from a National Registry and Multicenter Cohort Study.美国肾移植候选人和受者虚弱症的流行率:来自国家登记处和多中心队列研究的估计。
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