Walker Emma, Winter Rebecca, Hodgson Luke Eliot
Brighton and Sussex Medical School, 94 N - S Rd, Falmer, Brighton BN1 9PX, UK.
Department of Medical Education Brighton, Brighton and Sussex Medical School, Brighton and Hove BN1 9PX, UK.
Age Ageing. 2025 May 31;54(6). doi: 10.1093/ageing/afaf137.
To examine frailty assessments in older patients admitted to hospital, and explore associations with sex, admission and discharge status.
Worldwide, the prevalence of frailty is increasing. Stratifying frailty can be beneficial at a population level to improve public health and target local services. At an individual level, recognition of frailty can help inform prognosis and advanced planning. The Clinical Frailty Scale (CFS) is validated for predicting outcomes of older hospitalised adults.All patients admitted into two hospitals in the South-East of England between 1 January 2017 and 31 December 2022, aged ≥65 years old with an electronically recorded CFS were included.
Over the study period there were 100 933 admissions, representing 53 361 individual patients. A single admission was observed in 16 284 (30.5%), whilst 37 077 (69.5%) had more than one admission. The mean CFS was 4.62 (SD 1.66) and 49.5% were living with frailty (CFS ≥5). Across 6 years, before, during and after the Covid-19 pandemic, this percentage remained stable. Females had a higher average CFS than males (4.74 vs 4.46, P < 0.01). Patients with a single admission had a higher mean CFS than patients with subsequent readmissions. Patients who died during admission had a higher average CFS than those who survived to discharge (6.02 vs 4.52, P < 0.01).
This large cohort study of acutely admitted older adults found half were living with frailty. This highlights the importance of frailty identification to optimise personalised care. There was no significant change in frailty severity between 2018 and 2022.
研究住院老年患者的衰弱评估情况，并探讨其与性别、入院和出院状态的关联。
在全球范围内，衰弱的患病率正在上升。在人群层面分层评估衰弱有助于改善公共卫生状况并为当地服务提供目标导向。在个体层面，识别衰弱有助于判断预后并进行提前规划。临床衰弱量表（CFS）已被验证可用于预测老年住院患者的预后。纳入了2017年1月1日至2022年12月31日期间在英格兰东南部两家医院住院的所有年龄≥65岁且有电子记录CFS的患者。
在研究期间，共有100933次入院，涉及53361名个体患者。16284名患者（30.5%）仅有一次入院，而37077名患者（69.5%）有多次入院。CFS的平均值为4.62（标准差1.66），49.5%的患者存在衰弱（CFS≥5）。在新冠疫情之前、期间和之后的6年里，这一比例保持稳定。女性的平均CFS高于男性（4.74对4.46，P＜0.01）。单次入院患者的平均CFS高于再次入院患者。住院期间死亡的患者平均CFS高于存活至出院的患者（6.02对4.52，P＜0.01）。
这项针对急性入院老年患者的大型队列研究发现，一半患者存在衰弱。这凸显了识别衰弱对于优化个性化护理的重要性。2018年至2022年间衰弱严重程度没有显著变化。
