Prognostic factors in mobility disability among elderly patients in the emergency department: A single-center retrospective study

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY Accounts of Chemical Research Pub Date : 2024-04-17 DOI:10.1002/ams2.951

Akiyoshi Nagatomi, Haruaki Wakatake, Yoshihiro Masui, Shigeki Fujitani

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Abstract

Aim

We aimed to evaluate the clinical characteristics and outcomes of elderly critically ill patients and identify prognostic factors for mobility disability at discharge.

Methods

This single-center, retrospective cohort study investigated the period from April 2020 to January 2021. Patients ≥75 years old transferred to our emergency department and admitted to the intensive care unit (ICU) or intermediate unit in our hospital were eligible. Demographics, clinical characteristics, nutritional indicators, and nutritional screening scores were collected from chart reviews and analyzed. The primary outcome was the prevalence of mobility disability, compared to that of no mobility disability.

Results

A total of 124 patients were included in this present study. Median age was 83.0 years (interquartile range [IQR], 79.8–87.0 years) and 48 patients (38.7%) were female. Fifty-two patients (41.9%) could not walk independently at discharge (mobility disability group). The remaining 72 patients were in the no mobility disability group. Multiple logistic regression analyses revealed clinical frailty scale (CFS) score ≥5 (odds ratio [OR] = 6.63, 95% confidence interval [CI] = 2.51–17.52, p < 0.001), SOFA score ≥6 (OR = 6.11, 95% CI = 1.57–23.77, p = 0.009), and neurological disorder as the main cause on admission (OR = 4.48, 95% CI = 1.52–13.20, p = 0.006) were independent and significant prognostic factors for mobility disability at discharge.

Conclusion

Among elderly patients admitted to the emergency department, CFS ≥5, SOFA ≥6, and neurological disorders were associated with mobility disability at hospital discharge.

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急诊科老年患者行动不便的预后因素：单中心回顾性研究

目的我们旨在评估老年重症患者的临床特征和预后，并确定出院时行动不便的预后因素。方法本单中心回顾性队列研究调查了 2020 年 4 月至 2021 年 1 月期间的情况。年龄≥75岁的患者转入我院急诊科，并入住重症监护室（ICU）或中转病房。通过病历回顾收集并分析了患者的人口统计学特征、临床特征、营养指标和营养筛查评分。主要结果是与无行动障碍的患者相比，行动障碍的发生率。结果本研究共纳入 124 名患者。中位年龄为 83.0 岁（四分位距[IQR]为 79.8-87.0 岁），48 名患者（38.7%）为女性。52名患者（41.9%）出院时不能独立行走（行动不便组）。其余 72 名患者属于无行动障碍组。多重逻辑回归分析显示，临床虚弱量表（CFS）评分≥5（比值比 [OR] = 6.63，95% 置信区间 [CI] = 2.51-17.52，P < 0.001），SOFA 评分≥6（比值比 [OR] = 6.11，95% 置信区间 [CI] = 1.57-23.77，p = 0.009）、入院时主要病因为神经系统疾病（OR = 4.48，95% CI = 1.52-13.20，p = 0.006）是出院时行动不便的独立且显著的预后因素。结论在急诊科收治的老年患者中，CFS≥5、SOFA≥6和神经系统疾病与出院时的行动障碍有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.