The role of Frailty on Adverse Outcomes Among Older Patients with COVID-19.
The role of Frailty on Adverse Outcomes Among Older Patients with COVID-19.
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DOI：
10.1016/j.jinf.2020.09.029
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发表时间：
2020-12
期刊：
影响因子：
--
通讯作者：
Topaloğlu S
中科院分区：
文献类型：
--
作者：
Kundi H;Çetin EHÖ;Canpolat U;Aras S;Celik O;Ata N;Birinci S;Çay S;Özeke Ö;Tanboğa IH;Topaloğlu S
医院虚弱风险评分用于评估 ≥65 名 COVID-19 患者的虚弱状况 虚弱与较高的 COVID-19 不良后果风险相关 虚弱与合并症相结合，可以改善不良后果的预测 识别虚弱可以减少高风险的临床结果 虚弱的诊断和筛查是一种以更容易遭受 COVID-19 不良后果为特征的疾病，已成为重要的临床工具，受到与住院相关的医疗保健提供者强烈推荐老年人口。需要有数据来显示虚弱对感染 COVID-19 的患者的影响。这是在土耳其所有医院进行的一项全国性队列研究。所有 COVID-19 住院患者（≥ 65 岁）均包括在内。截至 2020 年 7 月 20 日仍活着且未出院的患者被排除在外。通过使用“医院虚弱风险评分”（HFRS）来评估虚弱程度。根据先前验证的切点，将患者分为三个虚弱风险组：低（<5 分）、中（5-15 分）和高（>15 分）。此外，HFRS ≥5 的患者被定义为虚弱。主要结局是衰弱组的院内死亡率。 2020年3月11日至2020年6月22日期间，总共纳入了来自土耳其所有81个省份的18,234名COVID-19患者。总共有 12,295 名 (67.4%) 患者被定义为虚弱（HFRS > 5），其中 2,801 名 (15.4%) 患者被归类为最高虚弱级别（HFRS > 15）。低、中、高医院衰弱风险组观察到的院内死亡率分别为 697 例（12.0%）、1,751 例（18.2%）和 867 例（31.0%）（p<0.001）。与低 HFRS (<5) 相比，中 HFRS (5-15) 的院内死亡率调整后比值比为 1.482 (1.334-1.646) 和 2.084；高 HFRS (>15) 的 95% CI，1.799-2.413。作为一种基于索赔的虚弱模型，HFRS 为临床医生和卫生系统提供了一种标准化工具，用于有效检测和分级 COVID-19 患者的虚弱程度。对老年人群进行基于虚弱的定制管理可以为治疗和预防策略提供更准确的风险分类。
Hospital Frailty Risk Score used to assess the frailty in ≥65 patients with COVID-19 Frailty was associated with a higher risk of adverse outcomes for COVID-19 Frailty improved the prediction of adverse outcomes when added to comorbidities Identifying frailty can be addressed to reduce high-risk clinical outcomes Diagnosis and screening of frailty, a condition characterized by an increased vulnerability to adverse outcomes of COVID-19, has emerged as an essential clinical tool which is strongly recommended by healthcare providers concerned with hospitalized elderly population. The data showing the role of frailty in patients infected with COVID-19 is needed. This was a nationwide cohort study conducted at all hospitals in Turkey. All COVID-19 hospitalized patients (≥ 65 years) were included. Patients who were alive and not discharged up to July 20, 2020, were excluded. The frailty was assessed by using the “Hospital Frailty Risk Score” (HFRS). Patients were classified into three risk groups of frailty based on previously validated cut points as low (<5 points), intermediate (5-15 points), and high (>15 points). Additionally, patients who had the HFRS of ≥5 were defined as frail. The primary outcome was in-hospital mortality rates by frailty group. Between March 11, 2020, and June 22, 2020, a total of 18,234 COVID-19 patients from all of 81 provinces of Turkey were included. Totally, 12,295 (67.4%) patients were defined as frail (HFRS of >5) of which 2,801 (15.4%) patients were categorized in the highest level of frailty (HFRS of >15). Observed in-hospital mortality rates were 697 (12.0%), 1,751 (18.2%) and 867 (31.0%) in low, intermediate and high hospital frailty risk, respectively (p<0.001). Compared with low HFRS (<5), the adjusted odds ratios for in-hospital mortality were 1.482 (1.334-1.646) for intermediate HFRS (5-15) and 2.084; 95% CI, 1.799-2.413 for high HFRS (>15). As a claims-based frailty model, the HFRS provides clinicians and health systems, a standardized tool for an effective detection and grading of frailty in patients in COVID-19. A frailty-based tailored management of the older population may provide a more accurate risk categorization for both therapeutic and preventive strategies.
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影响因子：
6.3
作者：
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通讯作者：
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影响因子：
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DOI：
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发表时间：
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影响因子：
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