The Association Between Frailty Evaluated by Clinical Frailty Scale and Mortality of Older Patients in the Emergency Department: A Prospective Cohort Study

IF 3.6 3区医学

Clinical Interventions in Aging Pub Date : 2024-07-25 DOI:10.2147/cia.s472991

Jin-Wei Lin, Pei-Ying Lin, Tse-Yao Wang, Ying-Ju Chen, David Hung-Tsang Yen, Hsien-Hao Huang

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引用次数: 0

Abstract

Background: Frailty epitomizes the most complex consequence of an aging population. This study aimed to evaluate the impact of frailty, measured using the Clinical Frailty Scale (CFS), on outcomes of older people in an emergency department (ED).
Methods: We conducted a prospective observational study enrolling patients aged 65 years and older in a medical center of Taiwan between March 8, 2021, and November 30, 2021. The primary outcome was 90-day mortality rate. Individuals were categorized into three groups based on the CFS scores. Logistic regression was employed to examine the influence of frailty on clinical outcomes following covariate adjustment. Survival analysis was conducted using Kaplan–Meier curves and Log rank tests.
Results: A total of 473 individuals were included in the study, with a mean age of 82.1 years, and 60.5% of them were males. The 90-day mortality rate was 10.6%. Among these groups, the CFS score 7– 9 group had the highest 90-day mortality rate (15.9%), followed by the CFS score 4– 6 group (8.0%) and the CFS score 1– 3 group (7.1%). The multiple logistic regression analyses demonstrated a significant impact of CFS score on prognosis, with adjusted odd ratios of 1.24 (95% CI 1.06– 1.47) for 90-day mortality, 1.18 (95% CI 1.06– 1.31) for hospitalization, and 1.30 (95% CI 1.12– 1.52) for 180-day mortality. The Kaplan–Meier curves revealed a significantly higher 90-day mortality rate for patients with high CFS scores (Log rank tests, p = 0.019).
Conclusion: In the older ED population, the severity of frailty assessed by the CFS emerged as a significant and important prognostic factor for hospitalization, 90-day mortality, and 180-day mortality.

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临床虚弱量表评估的虚弱程度与急诊科老年患者死亡率之间的关系：一项前瞻性队列研究

背景：虚弱是人口老龄化最复杂后果的缩影。本研究旨在通过临床虚弱量表（CFS）评估虚弱对急诊科（ED）老年人预后的影响：我们在 2021 年 3 月 8 日至 2021 年 11 月 30 日期间在台湾的一家医疗中心对 65 岁及以上的患者进行了前瞻性观察研究。主要结果是 90 天死亡率。根据 CFS 评分将患者分为三组。在进行协变量调整后，采用逻辑回归法检验虚弱对临床结果的影响。采用 Kaplan-Meier 曲线和对数秩检验进行生存分析：研究共纳入 473 人，平均年龄为 82.1 岁，其中 60.5% 为男性。90 天死亡率为 10.6%。其中，CFS 评分 7-9 组的 90 天死亡率最高（15.9%），其次是 CFS 评分 4-6 组（8.0%）和 CFS 评分 1-3 组（7.1%）。多重逻辑回归分析表明，CFS评分对预后有显著影响，90天死亡率的调整奇异比为1.24（95% CI 1.06-1.47），住院率为1.18（95% CI 1.06-1.31），180天死亡率为1.30（95% CI 1.12-1.52）。卡普兰-梅耶曲线显示，CFS评分高的患者90天死亡率明显更高（对数秩检验，P = 0.019）：结论：在老年急诊人群中，CFS评估的虚弱严重程度是影响住院、90天死亡率和180天死亡率的重要预后因素。

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来源期刊

Clinical Interventions in Aging GERIATRICS & GERONTOLOGY-

CiteScore

6.20

自引率

2.80%

发文量

193

期刊介绍： Clinical Interventions in Aging, is an online, peer reviewed, open access journal focusing on concise rapid reporting of original research and reviews in aging. Special attention will be given to papers reporting on actual or potential clinical applications leading to improved prevention or treatment of disease or a greater understanding of pathological processes that result from maladaptive changes in the body associated with aging. This journal is directed at a wide array of scientists, engineers, pharmacists, pharmacologists and clinical specialists wishing to maintain an up to date knowledge of this exciting and emerging field.