Impact of frailty on 30-day and 1-year mortality in hospitalised elderly patients with community-acquired pneumonia: a prospective observational study.
Impact of frailty on 30-day and 1-year mortality in hospitalised elderly patients with community-acquired pneumonia: a prospective observational study.
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DOI：
10.1136/bmjopen-2020-038370
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发表时间：
2020-10-31
期刊：
影响因子：
2.9
通讯作者：
Jiang C
中科院分区：
文献类型：
--
作者：
Luo J;Tang W;Sun Y;Jiang C
本研究评估了虚弱（一种更容易受到压力源影响的状态）对社区获得性肺炎 (CAP) 老年患者 30 天和 1 年死亡率的影响。主要假设是虚弱是老年 CAP 患者预后的独立预测因素。前瞻性、观察性、随访队列研究。中国北京一家拥有 2000 个床位的三级甲等医院。 2017年9月至2019年2月期间连续入住我院老年科的年龄≥65岁的CAP患者。主要结局为入院后30天和1年的全因死亡率。通过 Cox 回归分析评估虚弱（由虚弱表型定义）对老年 CAP 患者 30 天和 1 年死亡率的影响。该队列包括 256 名患者。中位年龄 (IQR) 为 86 (81-90) 岁，180 名参与者 (70.3%) 为男性。共有 171/256 (66.8%) 名患者身体虚弱。虚弱的患病率与年龄较大、女性、较低的体重指数、合并症、日常生活活动（ADL）限制和营养状况不佳显着相关。体弱的参与者比非体弱的参与者更有可能患有严重的 CAP (SCAP)（28.65% vs 9.41%，p<0.001）。体弱患者的 1 年死亡风险大约是非体弱患者的三倍（调整后 HR，2.70；95%CI，1.69 至 4.39）。 SCAP 患者的亚组分析显示，体弱组的 1 年死亡风险大约是非体弱组的三倍（调整后 HR，2.87；95%CI，1.58 至 4.96）。虚弱与 30 天死亡率之间的关联并不显着。这些研究结果表明，虚弱与 SCAP 以及老年 CAP 患者较高的 1 年死亡率密切相关，应尽早发现虚弱，以改善对这些患者的治疗。
This study evaluates the impact of frailty, which is a state of increased vulnerability to stressors, on 30-day and 1-year mortality among elderly patients with community-acquired pneumonia (CAP). The main hypothesis is that frailty is an independent predictor of prognosis in elderly CAP patients. Prospective, observational, follow-up cohort study. A 2000-bed tertiary care hospital in Beijing, China. Consecutive CAP patients aged ≥65 years admitted to the geriatric department of our hospital between September 2017 and February 2019. The primary outcomes were all-cause mortality at 30 days and 1 year after hospital admission. The impact of frailty (defined by frailty phenotype) on 30-day and 1-year mortality of elderly patients with CAP was assessed by Cox regression analysis. The cohort included 256 patients. The median (IQR) age was 86 (81–90) years, and 180 (70.3%) participants were men. A total of 171/256 (66.8%) patients were frail. The prevalence of frailty was significantly associated with older age, female gender, lower body mass index, comorbidities, limitations in activities of daily living (ADLs) and poor nutritional status. Frail participants were significantly more likely to have severe CAP (SCAP) than non-frail counterparts (28.65% vs 9.41%, p<0.001). The 1-year mortality risk was approximately threefold higher in frail patients (adjusted HR, 2.70; 95% CI, 1.69 to 4.39) than non-frail patients. Subgroup analysis of patients with SCAP showed that the 1-year mortality risk was approximately threefold higher in the frail group (adjusted HR, 2.87; 95% CI, 1.58 to 4.96) than in the non-frail group. The association between frailty and 30-day mortality was not significant. These findings suggest that frailty is strongly associated with SCAP and higher 1-year mortality in elderly patients with CAP, and frailty should be detected early to improve the management of these patients.
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影响因子：
4.3
作者：
Klausen, H. H.;Petersen, J.;Andersen, O.
通讯作者：
Andersen, O.
DOI：
10.1093/gerona/56.6.m366
发表时间：
2001-06-01
影响因子：
5.1
作者：
Rubenstein, LZ;Harker, JO;Vellas, B
通讯作者：
Vellas, B
DOI：
10.1111/j.1532-5415.2012.04054.x
发表时间：
2012-08-01
影响因子：
6.3
作者：
Collard, Rose M.;Boter, Han;Voshaar, Richard C. Oude
通讯作者：
Voshaar, Richard C. Oude
脆弱共识：行动呼吁。
DOI：
10.1016/j.jamda.2013.03.022
发表时间：
2013-06
影响因子：
7.6
作者：
Morley JE;Vellas B;van Kan GA;Anker SD;Bauer JM;Bernabei R;Cesari M;Chumlea WC;Doehner W;Evans J;Fried LP;Guralnik JM;Katz PR;Malmstrom TK;McCarter RJ;Gutierrez Robledo LM;Rockwood K;von Haehling S;Vandewoude MF;Walston J
通讯作者：
Walston J
DOI：
10.1056/nejmoa1500245
发表时间：
2015-07-30
期刊：
The New England journal of medicine
影响因子：
--
作者：
Jain S;Self WH;Wunderink RG;Fakhran S;Balk R;Bramley AM;Reed C;Grijalva CG;Anderson EJ;Courtney DM;Chappell JD;Qi C;Hart EM;Carroll F;Trabue C;Donnelly HK;Williams DJ;Zhu Y;Arnold SR;Ampofo K;Waterer GW;Levine M;Lindstrom S;Winchell JM;Katz JM;Erdman D;Schneider E;Hicks LA;McCullers JA;Pavia AT;Edwards KM;Finelli L;CDC EPIC Study Team
通讯作者：
CDC EPIC Study Team