Preadmission frailty status as a powerful predictor of dependency after discharge among hospitalized older patients: A clinical-based prospective study
Preadmission frailty status as a powerful predictor of dependency after discharge among hospitalized older patients: A clinical-based prospective study
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DOI：
10.1111/ggi.13537
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发表时间：
2018-12-01
影响因子：
3.3
通讯作者：
Yamatoku, Masato
中科院分区：
文献类型：
--
作者：
Koyama, Shingo;Katata, Hironobu;Yamatoku, Masato
目的虚弱是老年人几种不良健康结果的预测因子。然而，住院老年患者入院前虚弱状态与出院后依赖发生率之间的关系尚不清楚。本研究的目的是确定是否入院前虚弱状态可以预测住院老年患者出院后的依赖性。方法对一项前瞻性研究中年龄≥ 65岁的老年内科住院患者的队列资料进行分析。主要结果是从入院到出院后一个月的依赖发生率。使用Kihon检查表评估虚弱状态。我们将得分>= 8定义为虚弱，4-7定义为虚弱前，0-3定义为健壮。采用考克斯比例风险回归模型估计入院前虚弱状态与依赖发生率之间关系的风险比和置信区间。结果共分析了151名完成随访的参与者（平均年龄77.2岁[SD 6.9岁]）。虚弱、虚弱前期和健壮的患病率分别为22.5%、37.8%和39.7%。在随访期间，39名参与者（25.8%）发生了依赖性。与健康参与者相比，虚弱参与者（校正风险比4.29，95%置信区间1.72-10.69）的依赖性发生率显著升高。与健康受试者相比，虚弱前受试者（校正风险比1.27，95%置信区间0.51-10.69）的依赖性发生率没有显著升高。结论使用Kihon量表评估入院前虚弱状态可以预测住院老年患者出院后依赖性的发生率。Geriatr Gerontol Int 2018; 18：1609-1613.
Aim Frailty is a predictor of several adverse health outcomes in older adults. However, the relationship between preadmission frailty status and the incidence of dependency after discharge in hospitalized older patients remains unclear. The aim of the present study was to determine whether preadmission frailty status can predict dependency after discharge among hospitalized older patients. Methods We analyzed the cohort data for hospitalized older patients (aged >= 65 years) with internal medical problems obtained from a prospective study. The main outcome was the incidence of dependency from admission to a month after discharge. The frailty status was assessed using the Kihon Checklist. We defined scores of >= 8 as frail, 4-7 as pre-frail and 0-3 as robust. The Cox proportional hazards regression model was used to estimate the hazard ratios and confidence intervals of the relationships between preadmission frailty status and the incidence of dependency. Results A total of 151 participants who completed follow ups were analyzed (mean age 77.2 years [SD 6.9 years]). The prevalence of frailty, pre-frailty and robust was 22.5%, 37.8% and 39.7%, respectively. During the follow-up period, 39 participants (25.8%) had an incidence of dependency. Participants with frailty (adjusted hazard ratio 4.29, 95% confidence interval 1.72-10.69) had a significantly elevated incidence of dependency compared with that of robust participants. Participants with pre-frailty (adjusted hazard ratio 1.27, 95% confidence interval 0.51-10.69) had no significantly elevated incidence of dependency compared with robust participants. Conclusions The preadmission frailty status using the Kihon Checklist can predict the incidence of dependency after discharge among hospitalized older patients. Geriatr Gerontol Int 2018; 18: 1609-1613.