Validez predictiva de la escala de fragilidad Clinical Frailty Scale-España sobre el incremento de la dependencia tras el alta hospitalaria

IF 1.1 Q3 NURSING Enfermeria Intensiva Pub Date : 2024-04-01 DOI:10.1016/j.enfi.2023.07.003

S. Arias-Rivera PhDc, MsN, RN , M.M. Sánchez-Sánchez MsN, RN , E. Romero de-San-Pío MsN, RN , Y. Gabriel Santana-Padilla PhD, RN , M. Juncos-Gozalo RN , G. Via-Clavero PhD, RN , M.N. Moro-Tejedor PhD, RN , M. Raurell-Torredà PhD, RN , C. Andreu-Vázquez PhD, MsC, MvD , Grupo Fragil-Es-UCI

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Abstract

Introduction

The frailty present at hospital admission and the stressors to which patients are subjected during their stay may increase dependency at hospital discharge.

Objectives

To assess the predictive validity of the Clinical Frailty Scale-Spain (CFS-Spain) on increased dependency at 3 and 12 months (m) after hospital discharge.

Methodology

Multicentre cohort study in 2020-2022. Including patients with > 48 h stay in intensive care units (ICU) and non-COVID-19. Variables: pre-admission frailty (CFS-Spain). Sex, age, days of stay (ICU and hospital), dependency on admission and at 3 m and 12m after discharge (Barthel Index), muscle weakness (Medical Research Council Scale sum score < 48), hospital readmissions. Statistics: descriptive and multivariate analysis.

Results

254 cases were included. Thirty-nine per cent were women and the median [Q1-Q3] age was 67 [56-77] years. SAPS 3 on admission (median [Q1-Q3]): 62 [51-71] points.

Frail patients on admission (CFS-SAPS 5-9): 58 (23%). Dependency on admission (n = 254) vs. 3 m after hospital discharge (n = 171) vs. 12m after hospital discharge (n = 118): 1) Barthel 90-100: 82% vs. 68% vs. 65%. 2) Barthel 60-85: 15% vs. 15% vs. 20%. 3) Barthel 0-55: 3% vs. 17% vs 15%.

In the multivariate analysis, adjusted for the variables recorded, we observed that frail patients on admission (CFS-Spain 5-9) are 2.8 times (95%CI: 1.03-7.58; p = 0.043) more likely to increase dependency (Barthel 90-100 to < 90 or Barthel 85-60 to < 60) at 3 m post-discharge (with respect to admission) and 3.5 times (95%CI: 1.18-10.30; p = 0.024) more likely to increase dependency at 12m post-discharge. Furthermore, for each additional CFS-Spain point there is a 1.6-fold (95%CI: 1.01-2.23; p = 0.016) greater chance of increased dependency in the 12m following discharge.

Conclusions

CFS-Spain at admission can predict increased dependency at 3 m and 12m after hospital discharge.

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西班牙临床虚弱量表对出院后依赖性增加的预测有效性。

目的评估西班牙临床虚弱量表（CFS-Spain）对出院后 3 个月和 12 个月（m）依赖性增加的预测有效性。包括在重症监护室（ICU）住院 48 小时的患者和非 COVID-19 患者。变量：入院前虚弱程度（CFS-西班牙）。性别、年龄、住院天数（重症监护室和医院）、入院时及出院后 3m 和 12m 的依赖性（巴特尔指数）、肌无力（医学研究委员会量表总分< 48）、再入院情况。统计：描述性分析和多变量分析。女性占 39%，年龄中位数[Q1-Q3]为 67 [56-77]岁。入院时 SAPS 3（中位数[Q1-Q3]）为 62 [51-71] 分：入院时为体弱患者（CFS-SAPS 5-9）：58 (23%).入院时的依赖性（n = 254）与出院后 3 米的依赖性（n = 171）与出院后 12 米的依赖性（n = 118）：1) Barthel 90-100: 82% vs. 68% vs. 65%.2) Barthel 60-85：15% vs. 15% vs. 20%。3) Barthel 0-55：3% vs. 17% vs. 15%。在多变量分析中，根据所记录的变量进行调整后，我们发现入院时体弱的患者（CFS-Spain 5-9）是其他患者的 2.8 倍（95%CI：1.03-7.58；P = 0.与入院时相比，出院后 3 米依赖性增加（Barthel 90-100 到 90 或 Barthel 85-60 到 60）的可能性是入院时的 2.8 倍（95%CI：1.03-7.58；p = 0.043），出院后 12 米依赖性增加的可能性是入院时的 3.5 倍（95%CI：1.18-10.30；p = 0.024）。此外，每增加一个 CFS-Spain 积分，出院后 12m 依赖性增加的几率就会增加 1.6 倍 (95%CI: 1.01-2.23; p = 0.016)。

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来源期刊

Enfermeria Intensiva NURSING-

CiteScore

2.50

自引率

23.10%

发文量

期刊介绍： Enfermería Intensiva es el medio de comunicación por antonomasia para todos los profesionales de enfermería españoles que desarrollan su actividad profesional en las unidades de cuidados intensivos o en cualquier otro lugar donde se atiende al paciente crítico. Enfermería Intensiva publica cuatro números al año, cuyos temas son específicos para la enfermería de cuidados intensivos. Es la única publicación en español con carácter nacional y está indexada en prestigiosas bases de datos como International Nursing Index, MEDLINE, Índice de Enfermería, Cuiden, Índice Médico Español, Toxline, etc.