Association between laboratory data-based frailty index and clinical health outcomes in critically ill older patients: A retrospective correlational study.
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引用次数: 0
Abstract
Background: Although frailty assessment is crucial for understanding critically ill patients' prognosis, traditional frailty measures require substantial efforts and time from health care professionals. To address this limitation, the laboratory frailty index (FI-LAB) based on laboratory clinical data was developed. However, knowledge regarding its correlation with health outcomes among critically ill older patients is limited.
Aim: To identify the association between the FI-LAB and acute, mid- and long-term outcomes among critically ill older adults.
Study design: This retrospective correlational study used electronic health records of 2106 older patients who were admitted to the intensive care unit at a tertiary hospital in Seoul, Korea. Acute and mid-term outcomes included occurrence of delirium and in-hospital mortality, and the long-term outcome included 1-year mortality. Logistic regression was used to explore the relationships across FI-LAB, delirium, and in-hospital mortality, while Cox proportional hazard regression was used to analyse the relationship between FI-LAB and 1-year mortality.
Results: Frailty assessed by FI-LAB was significantly associated with increased risk of delirium (odds ratio [OR] = 6.21, 95% confidence interval [CI] = 2.31-25.39, p = .009), in-hospital mortality (OR = 2.38, 95% CI = 1.15-5.79, p = .014), and 1-year mortality (hazard ratio = 2.47, 95% CI = 1.16-5.25, p = .019) after controlling for covariates.
Conclusions: The study highlighted the importance of using FI-LAB for screening frailty in critically ill older adults. Health care providers can improve patients' acute, mid- and long-term outcomes to develop more individualised management plans based on FI-LAB scores.
Relevance to clinical practice: The FI-LAB score calculated from routine laboratory data can be used by nurses as a screening tool to identify frail older adults in critical care. Early detection of frailty would allow for closer monitoring and the implementation of interventions to reduce delirium and mortality.
背景：虽然衰弱评估对于了解危重患者的预后至关重要，但传统的衰弱测量需要卫生保健专业人员付出大量的努力和时间。为了解决这一局限性，基于实验室临床数据的实验室虚弱指数（FI-LAB）被开发出来。然而，关于其与危重老年患者健康结果的相关性的知识是有限的。目的：确定FI-LAB与危重老年人急性、中期和长期预后之间的关系。研究设计：这项回顾性相关研究使用了韩国首尔一家三级医院重症监护病房收治的2106名老年患者的电子健康记录。急性和中期结局包括谵妄的发生和住院死亡率，长期结局包括1年死亡率。采用Logistic回归探讨FI-LAB、谵妄和住院死亡率之间的关系，采用Cox比例风险回归分析FI-LAB与1年死亡率之间的关系。结果：在控制协变量后，FI-LAB评估的虚弱与谵妄风险增加（优势比[OR] = 6.21, 95%可信区间[CI] = 2.31-25.39, p = 0.009）、住院死亡率（OR = 2.38, 95% CI = 1.15-5.79, p = 0.014）和1年死亡率（风险比= 2.47,95% CI = 1.16-5.25, p = 0.019）显著相关。结论：该研究强调了使用FI-LAB筛查危重老年人虚弱的重要性。医疗保健提供者可以改善患者的急性、中期和长期预后，根据FI-LAB评分制定更个性化的管理计划。与临床实践的相关性：从常规实验室数据计算的FI-LAB评分可被护士用作筛查工具，以识别危重监护中的体弱老年人。早期发现虚弱将有助于更密切地监测和实施干预措施，以减少谵妄和死亡率。
期刊介绍：
Nursing in Critical Care is an international peer-reviewed journal covering any aspect of critical care nursing practice, research, education or management. Critical care nursing is defined as the whole spectrum of skills, knowledge and attitudes utilised by practitioners in any setting where adults or children, and their families, are experiencing acute and critical illness. Such settings encompass general and specialist hospitals, and the community. Nursing in Critical Care covers the diverse specialities of critical care nursing including surgery, medicine, cardiac, renal, neurosciences, haematology, obstetrics, accident and emergency, neonatal nursing and paediatrics.
Papers published in the journal normally fall into one of the following categories:
-research reports
-literature reviews
-developments in practice, education or management
-reflections on practice
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