Frailty status changes are associated with healthcare utilization and subsequent mortality in the elderly population.
Frailty status changes are associated with healthcare utilization and subsequent mortality in the elderly population.
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DOI：
10.1186/s12889-021-10688-x
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发表时间：
2021-04-01
影响因子：
4.5
通讯作者：
Lin CC
中科院分区：
文献类型：
--
作者：
Li CM;Lin CH;Li CI;Liu CS;Lin WY;Li TC;Lin CC
本研究确定（1）1年随访后虚弱状态的变化是否与医疗保健利用相关，并评估（2）1年随访后虚弱状态的变化和医疗保健利用是否与台湾人群样本中的全因死亡率相关。这项工作是一项基于人群的前瞻性队列研究，涉及2009年年龄≥65岁的居民。共有548名在随后一年接受随访的老年患者被纳入当前数据分析。在基线和1年时测量Fried虚弱表型。在第二次访谈前2个月内，通过访谈者进行的标准化问卷调查收集每个专科医生的门诊就诊、急诊利用和住院信息。通过国家死亡数据库的索引核实死亡人数。在随后的1年随访中，分别有73（13.3%）、356（64.9%）和119（21.7%）例老年参与者表现出恶化、状态无变化和虚弱状态改善。多变量logistic分析显示，与基线时健康且1年后虚弱状态不变的老年人相比，虚弱状态更差的老年人使用任何类型的门诊药物的风险更高（比值比[OR] 1.94，95%置信区间[CI] 1.02-3.71）。经过多变量调整后，在未改变的虚弱前或虚弱中，门诊利用率高的参与者的死亡率显著高于门诊就诊率低的参与者。（风险比[HR] 2.79，95% CI：1.46-5.33）和虚弱至虚弱前/健壮组（HR 9.32，95% CI：3.82-22.73），如果使用不变的稳健性和低门诊访视组作为参考组。1年后或基线时，与虚弱状态相关的疾病显著影响门诊访视，并可能增加医疗费用。虚弱状态和门诊就诊次数的综合变化与死亡率增加有关。在线版本包含补充材料，可通过10.1186/s12889-021-10688-x获得。
This study determined (1) whether a change in frailty status after a 1 year follow up is associated with healthcare utilization and evaluated (2) whether a change in frailty status after a 1 year follow up and health care utilization are associated with all-cause mortality in a sample of Taiwan population. This work is a population-based prospective cohort study involving residents aged ≥65 years in 2009. A total of 548 elderly patients who received follow-ups in the subsequent year were included in the current data analysis. Fried frailty phenotype was measured at baseline and 1 year. Information on the outpatient visits of each specialty doctor, emergency care utilization, and hospital admission during the 2 month period before the second interview was collected through standardized questionnaires administered by an interviewer. Deaths were verified by indexing to the national database of deaths. At the subsequent 1 year follow-up, 73 (13.3%), 356 (64.9%), and 119 (21.7%) elderly participants exhibited deterioration, no change in status, and improvement in frailty states, respectively. Multivariate logistic analysis showed the high risk of any type of outpatient use (odds ratios [OR] 1.94, 95% confidence interval [CI] 1.02–3.71) among older adults with worse frailty status compared with those who were robust at baseline and had unchanged frailty status after 1 year. After multivariate adjustment, participants with high outpatient clinic utilization had significantly higher mortality than those with low outpatient clinic visits among unchanged pre-frail or frail (hazard ratios [HR] 2.79, 95% CI: 1.46–5.33) and frail to pre-frail/robust group (HR 9.32, 95% CI: 3.82–22.73) if the unchanged robustness and low outpatient clinic visits group was used as the reference group. The conditions associated with frailty status, either after 1 year or at baseline, significantly affected the outpatient visits and may have increased medical expenditures. Combined change in frailty status and number of outpatient visits is related to increased mortality. The online version contains supplementary material available at 10.1186/s12889-021-10688-x.
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影响因子：
2.8
作者：
Bock JO;König HH;Brenner H;Haefeli WE;Quinzler R;Matschinger H;Saum KU;Schöttker B;Heider D
通讯作者：
Heider D
影响因子：
2.8
作者：
Fillion, Vanessa;Sirois, Marie-Josee;Jean, Sonia
通讯作者：
Jean, Sonia
影响因子：
3.3
作者：
Koyama, Shingo;Katata, Hironobu;Yamatoku, Masato
通讯作者：
Yamatoku, Masato
影响因子：
2.8
作者：
Lin, Chen-Fang;Wang, Chun-Yu;Bai, Chyi-Huey
通讯作者：
Bai, Chyi-Huey
DOI：
10.1159/000381229
发表时间：
2015-01-01
期刊：
FRAILTY IN AGING: BIOLOGICAL, CLINICAL AND SOCIAL IMPLICATIONS
影响因子：
--
作者：
Cameron, Ian D.;Kurrle, Susan E.
通讯作者：
Kurrle, Susan E.