危重症患者中衰弱的患病率及其对器官支持需求和临床结局的影响：一项前瞻性观察性单中心研究
Prevalence of frailty and its effect on requirement of organ support and clinical outcomes in critically ill patients: a prospective observational single center study.
作者信息
Singh Dhananjay Kumar, Ganesh Venkata, Sahni Neeru, Kannamani Balaji, Saini Vikas, Yaddanapudi Laxminarayana
机构信息
Department of Anaesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India.
出版信息
BMC Anesthesiol. 2025 Apr 26;25(1):215. doi: 10.1186/s12871-025-03096-w.
BACKGROUND
Assessing pre-hospital frailty on ICU admission can help in risk stratification. We conducted this prospective, observational study to determine the prevalence of frailty in critically ill patients based on Clinical Frailty Scale (CFS) within 24 h of admission and to study effect of frailty on requirement of organ support and clinical outcome.
METHODS
The study was registered in Clinical Trials Registry-India (CTRI/2021/04/032782) on 13/04/2021. After approval from IEC and written informed consent, all adult patients admitted to our ICU from April 15th, 2021 to April 14th, 2022 were included. The patients were categorized as Frail & Non-Frail, defining frailty as CFS ≥ 5, two weeks before index admission. The groups were compared for requirement of organ support (vasoactive support, mechanical ventilation, renal replacement therapy) and clinical outcomes (hospital acquired infections (HAI), hospital and ICU length of stay (LOS) and hospital, ICU and 30-day mortality).
RESULT
Out of 358 admissions, 317 were enrolled. The demographic data were comparable except for higher family income amongst frail patients, p < 0.001. The prevalence of frailty was 24.6%. A significantly higher number of frail patients required vasoactive support (p = 0.006). Incidence of HAI in frail group was significantly higher (48.7%) as compared to non-frail group (20.9%) (p < 0.001). The median ICU LOS was 7 days [IQR, 3-7] in frail compared to 6 days [IQR,3-10] in non-frail group, p = 0.051. The median hospital LOS in frail patients was 18 days [IQR,10-32] compared to 15 days [IQR, 8.25-26] in non-frail, p = 0.005. ICU, hospital and 30-day mortality were significantly higher in frail patients, p < 0.01.
CONCLUSION
The prevalence of frailty in ICU patients was 24.6% and a higher number of frail patients had requirement of vasopressor support and incidence of HAI. Additionally, frail patients also had longer hospital LOS and higher ICU, hospital and 30-day mortality.
TRIAL REGISTRATION
CTRI/2021/04/032782.
背景
评估入住重症监护病房（ICU）时的院前虚弱状况有助于进行风险分层。我们开展了这项前瞻性观察性研究，以确定危重症患者在入院24小时内基于临床虚弱量表（CFS）的虚弱患病率，并研究虚弱对器官支持需求和临床结局的影响。
方法
该研究于2021年4月13日在印度临床试验注册中心（CTRI/2021/04/032782）注册。经独立伦理委员会（IEC）批准并获得书面知情同意后，纳入了2021年4月15日至2022年4月14日入住我们ICU的所有成年患者。患者被分为虚弱组和非虚弱组，将虚弱定义为在本次入院前两周CFS≥5。比较两组的器官支持需求（血管活性药物支持、机械通气、肾脏替代治疗）和临床结局（医院获得性感染（HAI）、住院和ICU住院时间（LOS）以及医院、ICU和30天死亡率）。
结果
在358例入院患者中，317例被纳入研究。除了虚弱患者的家庭收入较高外（p<0.001），两组的人口统计学数据具有可比性。虚弱患病率为24.6%。需要血管活性药物支持的虚弱患者数量显著更多（p=0.006）。虚弱组的HAI发生率显著高于非虚弱组（48.7%对比20.9%）（p<0.001）。虚弱组的ICU住院时间中位数为7天[四分位间距（IQR），3 - 7]，而非虚弱组为6天[IQR，3 - 10]，p=0.051。虚弱患者的住院时间中位数为18天[IQR，10 - 32]，非虚弱患者为15天[IQR，8.25 - 26]，p=0.005。虚弱患者的ICU、医院和30天死亡率显著更高，p<0.01。
结论
ICU患者的虚弱患病率为24.6%，更多虚弱患者需要血管升压药支持且HAI发生率更高。此外，虚弱患者的住院时间也更长，ICU、医院和30天死亡率更高。
试验注册
CTRI/2021/04/032782
Zotero 插件