Sanchez Miriam M, Sabillon Chris A, Paduano Stephanie J, Egwim Chukwuma, Ankoma-Sey Victor
Department of Internal Medicine, Texas Health Resources (HEB/Denton), Bedford, TX 76022, USA.
Department of Electrical and Computer Engineering, University of Texas at Austin, Austin, TX 78712, USA.
J Clin Med. 2025 Apr 30;14(9):3112. doi: 10.3390/jcm14093112.
Frailty is increasingly recognized as a critical predictor of adverse outcomes in older adults, particularly those with cancer. However, the role of frailty-distinct from comorbidity burden-has not been fully characterized in older adults hospitalized with cholangiocarcinoma (CCA), a rare but aggressive malignancy with rising incidence in the aging population. A retrospective cross-sectional analysis of the Nationwide Inpatient Sample (NIS) 2019-2022 was performed. Adult inpatients aged ≥ 65 with CCA-related ICD-10 codes were identified. Patients were stratified into frailty categories based on the Hospital Frailty Risk Score (HFRS). Multivariable regression models were used to assess associations with in-hospital mortality, length of stay (LOS), and hospital charges. Among 18,785 hospitalizations, the in-hospital mortality rate was 7.18%. High frailty conferred an eight-fold increased risk of mortality, a 70% longer LOS, and 52% higher charges compared to low frailty. Elixhauser comorbidity scores were not significantly associated with outcomes. These findings support the use of frailty screening to guide inpatient care planning and optimize outcomes in older adults with CCA.
衰弱日益被认为是老年人不良结局的关键预测因素，尤其是患有癌症的老年人。然而，在因胆管癌（CCA）住院的老年人中，衰弱（与合并症负担不同）的作用尚未得到充分描述，CCA是一种罕见但侵袭性强的恶性肿瘤，在老年人群中的发病率不断上升。对2019 - 2022年全国住院患者样本（NIS）进行了回顾性横断面分析。确定了年龄≥65岁且具有与CCA相关的国际疾病分类第十版（ICD - 10）编码的成年住院患者。根据医院衰弱风险评分（HFRS）将患者分层为衰弱类别。使用多变量回归模型评估与住院死亡率、住院时间（LOS）和住院费用的关联。在18785次住院治疗中，住院死亡率为7.18%。与低衰弱相比，高衰弱使死亡风险增加8倍，住院时间延长70%，费用增加52%。埃利克斯豪泽合并症评分与结局无显著关联。这些发现支持使用衰弱筛查来指导住院护理计划并优化CCA老年患者的结局。
