Alotaibi Faris, Alshibani Abdullah, Banerjee Jay, Manktelow Brad
Department of Emergency Medical Care, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
Department of Population Health Sciences, College of Life Sciences, University of Leicester, Leicester, UK.
Eur Geriatr Med. 2025 Jun 2. doi: 10.1007/s41999-025-01242-8.
Studies have shown that hospital-related adverse events (AEs) affect older hospitalised patients. Frailty is an age-related syndrome of increased vulnerability, the risk of abrupt and extreme health changes, and the risk of suffering an adverse event (AE). Most of the published work focuses on the relationship between age alone and AEs' incidence. We aim to examine the association between frailty and the incidence of hospital-related AEs among hospitalised older adults in the published literature.
A comprehensive search of Ovid MEDLINE, CINAHL, Scopus, and Web of Science databases was conducted between January and February 2024. Studies were included if they provide original data in English, regardless of methodology. In addition, the reference lists of all included studies were manually screened to identify any further eligible studies. The narrative synthesis followed the Cochrane methodology.
This review includes 19 observational studies, with the USA being the most common study location. Various frailty tools and definitions were used, with the frailty index (FI) being the most frequently employed tool. Hospital-acquired infections, including pneumonia, urinary tract infections (UTIs), sepsis and wound infections, were the most frequently reported adverse events, followed by delirium. In addition, falls, pressure ulcers and venous thromboembolism were also commonly documented.
This review found that frailty is associated with an increased risk of hospital-acquired infections, in-hospital delirium, falls and pressure ulcers. More extensive and comprehensive studies are needed to focus on patient safety incidents among frail hospitalised individuals.
研究表明，与医院相关的不良事件（AE）会影响住院的老年患者。衰弱是一种与年龄相关的综合征，其特征是易感性增加、健康状况突然和极端变化的风险以及发生不良事件（AE）的风险。大多数已发表的研究仅关注年龄与AE发生率之间的关系。我们旨在研究已发表文献中住院老年人衰弱与医院相关AE发生率之间的关联。
于2024年1月至2月对Ovid MEDLINE、CINAHL、Scopus和Web of Science数据库进行了全面检索。纳入的研究需以英文提供原始数据，不限研究方法。此外，对所有纳入研究的参考文献列表进行了人工筛选，以确定是否有其他符合条件的研究。叙述性综合分析遵循Cochrane方法。
本综述纳入了19项观察性研究，美国是最常见的研究地点。使用了各种衰弱工具和定义，其中衰弱指数（FI）是最常用的工具。医院获得性感染，包括肺炎、尿路感染（UTI）、败血症和伤口感染，是最常报告的不良事件，其次是谵妄。此外，跌倒、压疮和静脉血栓栓塞也很常见。
本综述发现，衰弱与医院获得性感染、院内谵妄、跌倒和压疮的风险增加有关。需要进行更广泛和全面的研究，以关注衰弱住院患者的患者安全事件。
