Schindele Denise, Berger Marc Moritz, Gnass Irmela
Paracelsus Medizinische Privatuniversität, Institut für Pflegewissenschaft und -praxis, Zentrum für Public Health und Versorgungsforschung, Strubergasse 21, 5020, Salzburg, Österreich.
Regionale Kliniken Holding Ludwigsburg, RKH Akademie, Kurt-Lindemann-Weg 10, 71706, Markgröningen, Deutschland.
Med Klin Intensivmed Notfmed. 2025 Apr 23. doi: 10.1007/s00063-025-01280-x.
Frailty syndrome is characterized by a decline in physiological reserves and a reduced resistance to internal and external stressors. In addition to a higher mortality rate, patients who are frail are more prone to complications during hospitalization, including admission to an intensive care unit (ICU). Studies indicated that frailty syndrome may serve as a predictor of readmission to the ICU. The impact of frailty syndrome on readmission to an ICU in Germany remains to be elucidated, as extant research primarily originates from non-German-speaking countries and is only partially transferable.
The primary objective of this study is to characterize the syndrome of frailty (measured using the Clinical Frailty Scale [CFS] ≥ 5) as a potential risk factor for readmission to the ICU. Secondly, the study will examine which factors, specifically nursing and medical measures on intermediate care and normal wards, can influence readmissions to the ICU.
The study employs an explanatory sequential mixed-methods design, comprising a quantitative and a qualitative research phase. In the quantitative phase, a prospective cohort study will be conducted to investigate the association between frailty syndrome and ICU readmissions (≤ 30 days after discharge or during the same hospital stay) in patients ≥ 65 years of age. Concurrently, a document analysis will be conducted in the qualitative phase to identify care measures that could influence readmission.
The primary hypothesis of this study is that patients diagnosed with frailty syndrome (CFS ≥ 5) exhibit a higher risk of readmission to the ICU compared to non-frail patients. This inquiry will be conducted in the quantitative phase of the study. The qualitative research component is designed to elucidate non-intensive care measures that may influence readmission.
衰弱综合征的特征是生理储备下降以及对内部和外部应激源的抵抗力降低。除了死亡率较高外，衰弱患者在住院期间更容易出现并发症，包括入住重症监护病房（ICU）。研究表明，衰弱综合征可能是再次入住ICU的一个预测指标。衰弱综合征对德国ICU再入院的影响仍有待阐明，因为现有研究主要来自非德语国家，且仅部分可移植。
本研究的主要目的是将衰弱综合征（使用临床衰弱量表[CFS]测量≥5）表征为再次入住ICU的潜在风险因素。其次，该研究将考察哪些因素，特别是中级护理病房和普通病房的护理及医疗措施，会影响再次入住ICU。
本研究采用解释性序贯混合方法设计，包括定量和定性研究阶段。在定量阶段，将进行一项前瞻性队列研究，以调查65岁及以上患者中衰弱综合征与ICU再入院（出院后≤30天或在同一次住院期间）之间的关联。同时，在定性阶段将进行文献分析，以确定可能影响再入院的护理措施。
本研究的主要假设是，与非衰弱患者相比，被诊断为衰弱综合征（CFS≥5）的患者再次入住ICU的风险更高。这一探究将在研究的定量阶段进行。定性研究部分旨在阐明可能影响再入院的非重症护理措施。
