Frailty in general medicine patients receiving geriatric medicine liaison services is predictive of adverse outcomes.

IF 1.4 4区医学 Q4 GERIATRICS & GERONTOLOGY Australasian Journal on Ageing Pub Date : 2024-10-08 DOI:10.1111/ajag.13374

Mark Q Thompson, Nur-E-Zannat Fatema, Graeme R Tucker, Ashna Khalid, Yue Huang, Carla R Smyth, Solomon Yu, Renuka Visvanathan

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Abstract

Introduction: Frailty is in an increasing focus for acute care systems due to its association with adverse health outcomes. The Clinical Frailty Scale (CFS) is a judgement-based frailty assessment tool, which classifies the frailty status of older adults, but more research involving general medicine inpatients is necessary. The objectives of this study were to describe the predictive ability of CFS, administered by geriatric medicine trained nurses, for adverse outcomes including the following: acute unit and total length of stay (LOS), new nursing home (NH) admission, 12-month mortality and readmission within 30-day.

Methods: Design Retrospective study. Participants Patients admitted under general medicine unit and seen by the geriatric medicine liaison team in one general hospital. Main Measure CFS.

Results: Of 394 patients included, 60% were mild-moderately frail, and 21% severely frail. In a multivariable analysis, patients classified as severely frail (CFS 7-9) had significantly high odds of death during admission (OR = 13.64), new NH admission (OR = 34.97) and acute LOS (OR = 1.74), compared to non-frail patients (CFS1-4). Mild-moderately frail (CFS 5-6) patients had significantly higher odds for new NH admission (OR = 4.36), acute unit LOS (OR = 1.49) and total LOS (OR = 1.61) compared to non-frail patients. In a Cox regression multivariable survival analysis, the severely frail had a sixfold significantly higher likelihood (HR = 6.19) of 12-month mortality, and the mild-moderately frail had a doubled likelihood (HR = 2.13), compared to the non-frail.

Conclusions: The CFS has clinical utility for identifying general medicine older inpatients at-risk of various adverse outcomes.

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接受老年医学联络服务的普通内科病人体质虚弱可预测不良后果。

简介由于老年虚弱与不良健康后果有关，因此老年虚弱越来越受到急症护理系统的重视。临床虚弱量表（CFS）是一种基于判断的虚弱评估工具，可对老年人的虚弱状况进行分类，但有必要开展更多涉及普通内科住院病人的研究。本研究的目的是描述由接受过老年医学培训的护士实施的临床虚弱度量表（CFS）对不良后果的预测能力，不良后果包括：急性病区和总住院时间（LOS）、新入住疗养院（NH）、12 个月死亡率和 30 天内再次入院：设计：回顾性研究。参与者一家综合医院的全科医学科收治并由老年医学联络小组诊治的患者。主要测量 CFS：在纳入的 394 名患者中，60% 为轻度-中度体弱，21% 为重度体弱。在一项多变量分析中，与非体弱患者（CFS1-4）相比，被归类为严重体弱（CFS 7-9）的患者在入院期间死亡（OR = 13.64）、新入院（OR = 34.97）和急性LOS（OR = 1.74）的几率明显较高。与非体弱患者相比，轻度-中度体弱（CFS 5-6）患者新入住 NH 的几率（OR = 4.36）、急性单元 LOS（OR = 1.49）和总 LOS（OR = 1.61）明显更高。在 Cox 回归多变量生存分析中，与非体弱者相比，严重体弱者 12 个月内死亡的可能性（HR = 6.19）显著增加了六倍，轻度-中度体弱者的可能性（HR = 2.13）增加了一倍：CFS对识别有各种不良后果风险的普通内科老年住院患者具有临床实用性。

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

Australasian Journal on Ageing 医学-老年医学

CiteScore

3.10

自引率

6.20%

发文量

114

审稿时长

>12 weeks

期刊介绍： Australasian Journal on Ageing is a peer reviewed journal, which publishes original work in any area of gerontology and geriatric medicine. It welcomes international submissions, particularly from authors in the Asia Pacific region.