Impact of Frailty on Care Burden of Hospitalized Older Adults Receiving Colonoscopy: A 2016-2020 Nationwide Inpatient Sample Analysis.

IF 3.7 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Journal of Gastroenterology and Hepatology Pub Date : 2025-05-08 DOI:10.1111/jgh.16998

Chao-Ling Cheng, Po-Jui Huang, Shih-Ping Huang

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引用次数: 0

Abstract

Background: Colonoscopy is a widely used diagnostic and therapeutic procedure. The impact of frailty on outcomes of hospitalized older patients undergoing colonoscopy is unclear. This study aims to evaluate associations between frailty and outcomes of hospitalized older adults undergoing colonoscopy.

Methods: Data were extracted from the Nationwide Inpatient Sample (NIS), 2016-2020. Hospitalized patients ≥ 65 years old who underwent colonoscopy were included. Frailty was assessed using a modified frailty index (mFI), and frail was defined as mFI ≥ 0.27. The primary outcomes were in-hospital mortality, nonroutine discharge, prolonged length of stay (LOS) (≥ 75th percentile), postprocedural dysrhythmia, and other postprocedural complications.

Results: A total of 142 257 hospitalized older adults were included, with 29 558 categorized as frail. The mean age was 77 years, and 54% were males. Frail patients had significantly higher in-hospital mortality (2.7% vs. 1.7%), nonroutine discharge (27.8% vs. 19.6%), prolonged LOS (33.9% vs. 24.2%), and postprocedural dysrhythmia (46.3% vs. 29.2%) compared to nonfrail patients (all, p < 0.001). After adjusting for covariates, frailty remained significantly associated with increased risks of in-hospital mortality (odds ratio [OR] = 1.60), nonroutine discharge (OR = 1.62), prolonged LOS (OR = 1.62), and postprocedural dysrhythmia (OR = 2.12). Stratified analyses by sex and age obtained the same results across all subgroups.

Discussion: Frailty is significantly associated with adverse outcomes in hospitalized older adults undergoing colonoscopy. These findings highlight the importance of increased periprocedural care for frail patients to improve clinical outcomes and optimize resource utilization.

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虚弱对接受结肠镜检查的住院老年人护理负担的影响：2016-2020年全国住院患者样本分析

背景：结肠镜检查是一种广泛应用的诊断和治疗方法。虚弱对住院老年患者结肠镜检查结果的影响尚不清楚。本研究旨在评估接受结肠镜检查的住院老年人虚弱与预后之间的关系。方法：数据提取自2016-2020年全国住院患者样本（NIS）。年龄≥65岁的住院患者接受结肠镜检查。使用改良的虚弱指数（mFI）评估虚弱，mFI≥0.27定义虚弱。主要结局为住院死亡率、非正常出院、住院时间延长（≥75百分位数）、术后心律失常和其他术后并发症。结果：共纳入142 257例住院老年人，其中虚弱者29 558例。平均年龄77岁，男性占54%。与非体弱患者相比，体弱患者的住院死亡率（2.7% vs. 1.7%）、非常规出院（27.8% vs. 19.6%）、延长的LOS （33.9% vs. 24.2%）和术后心律失常（46.3% vs. 29.2%）显著高于非体弱患者。这些发现强调了增加对虚弱患者的围手术期护理对改善临床结果和优化资源利用的重要性。

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

Journal of Gastroenterology and Hepatology 医学-胃肠肝病学

CiteScore

7.90

自引率

2.40%

发文量

326

审稿时长

2.3 months

期刊介绍： Journal of Gastroenterology and Hepatology is produced 12 times per year and publishes peer-reviewed original papers, reviews and editorials concerned with clinical practice and research in the fields of hepatology, gastroenterology and endoscopy. Papers cover the medical, radiological, pathological, biochemical, physiological and historical aspects of the subject areas. All submitted papers are reviewed by at least two referees expert in the field of the submitted paper.