S. Arias-Rivera PhDc, MsN, RN , M.M. Sánchez-Sánchez MsN, RN , E. Romero de-San-Pío MsN, RN , Y. Gabriel Santana-Padilla PhD, RN , M. Juncos-Gozalo RN , G. Via-Clavero PhD, RN , M.N. Moro-Tejedor PhD, RN , M. Raurell-Torredà PhD, RN , C. Andreu-Vázquez PhD, MsC, MvD , Grupo Fragil-Es-UCI
{"title":"西班牙临床虚弱量表对出院后依赖性增加的预测有效性。","authors":"S. Arias-Rivera PhDc, MsN, RN , M.M. Sánchez-Sánchez MsN, RN , E. Romero de-San-Pío MsN, RN , Y. Gabriel Santana-Padilla PhD, RN , M. Juncos-Gozalo RN , G. Via-Clavero PhD, RN , M.N. Moro-Tejedor PhD, RN , M. Raurell-Torredà PhD, RN , C. Andreu-Vázquez PhD, MsC, MvD , Grupo Fragil-Es-UCI","doi":"10.1016/j.enfi.2023.07.003","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><p>The frailty present at hospital admission and the stressors to which patients are subjected during their stay may increase dependency at hospital discharge.</p></div><div><h3>Objectives</h3><p>To assess the predictive validity of the Clinical Frailty Scale-Spain (CFS-Spain) on increased dependency at 3 and 12 months (m) after hospital discharge.</p></div><div><h3>Methodology</h3><p>Multicentre cohort study in 2020-2022. Including patients with ><!--> <!-->48<!--> <!-->h stay in intensive care units (ICU) and non-COVID-19. Variables: pre-admission frailty (CFS-Spain). Sex, age, days of stay (ICU and hospital), dependency on admission and at 3<!--> <!-->m and 12m after discharge (Barthel Index), muscle weakness (Medical Research Council Scale sum score <<!--> <!-->48), hospital readmissions. Statistics: descriptive and multivariate analysis.</p></div><div><h3>Results</h3><p>254 cases were included. Thirty-nine per cent were women and the median [Q1-Q3] age was 67 [56-77] years. SAPS 3 on admission (median [Q1-Q3]): 62 [51-71] points.</p><p>Frail patients on admission (CFS-SAPS 5-9): 58 (23%). Dependency on admission (n<!--> <!-->=<!--> <!-->254) vs. 3<!--> <!-->m after hospital discharge (n<!--> <!-->=<!--> <!-->171) vs. 12m after hospital discharge (n<!--> <!-->=<!--> <!-->118): 1) Barthel 90-100: 82% vs. 68% vs. 65%. 2) Barthel 60-85: 15% vs. 15% vs. 20%. 3) Barthel 0-55: 3% vs. 17% vs 15%.</p><p>In the multivariate analysis, adjusted for the variables recorded, we observed that frail patients on admission (CFS-Spain 5-9) are 2.8 times (95%CI: 1.03-7.58; p<!--> <!-->=<!--> <!-->0.043) more likely to increase dependency (Barthel 90-100 to <<!--> <!-->90 or Barthel 85-60 to <<!--> <!-->60) at 3<!--> <!-->m post-discharge (with respect to admission) and 3.5 times (95%CI: 1.18-10.30; p<!--> <!-->=<!--> <!-->0.024) more likely to increase dependency at 12m post-discharge. Furthermore, for each additional CFS-Spain point there is a 1.6-fold (95%CI: 1.01-2.23; p<!--> <!-->=<!--> <!-->0.016) greater chance of increased dependency in the 12m following discharge.</p></div><div><h3>Conclusions</h3><p>CFS-Spain at admission can predict increased dependency at 3<!--> <!-->m and 12m after hospital discharge.</p></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"35 2","pages":"Pages 79-88"},"PeriodicalIF":1.1000,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1130239923000731/pdfft?md5=0687d6270925d033ff6aa2c0551aa778&pid=1-s2.0-S1130239923000731-main.pdf","citationCount":"0","resultStr":"{\"title\":\"Validez predictiva de la escala de fragilidad Clinical Frailty Scale-España sobre el incremento de la dependencia tras el alta hospitalaria\",\"authors\":\"S. Arias-Rivera PhDc, MsN, RN , M.M. Sánchez-Sánchez MsN, RN , E. Romero de-San-Pío MsN, RN , Y. Gabriel Santana-Padilla PhD, RN , M. Juncos-Gozalo RN , G. Via-Clavero PhD, RN , M.N. Moro-Tejedor PhD, RN , M. Raurell-Torredà PhD, RN , C. Andreu-Vázquez PhD, MsC, MvD , Grupo Fragil-Es-UCI\",\"doi\":\"10.1016/j.enfi.2023.07.003\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Introduction</h3><p>The frailty present at hospital admission and the stressors to which patients are subjected during their stay may increase dependency at hospital discharge.</p></div><div><h3>Objectives</h3><p>To assess the predictive validity of the Clinical Frailty Scale-Spain (CFS-Spain) on increased dependency at 3 and 12 months (m) after hospital discharge.</p></div><div><h3>Methodology</h3><p>Multicentre cohort study in 2020-2022. Including patients with ><!--> <!-->48<!--> <!-->h stay in intensive care units (ICU) and non-COVID-19. Variables: pre-admission frailty (CFS-Spain). Sex, age, days of stay (ICU and hospital), dependency on admission and at 3<!--> <!-->m and 12m after discharge (Barthel Index), muscle weakness (Medical Research Council Scale sum score <<!--> <!-->48), hospital readmissions. Statistics: descriptive and multivariate analysis.</p></div><div><h3>Results</h3><p>254 cases were included. Thirty-nine per cent were women and the median [Q1-Q3] age was 67 [56-77] years. SAPS 3 on admission (median [Q1-Q3]): 62 [51-71] points.</p><p>Frail patients on admission (CFS-SAPS 5-9): 58 (23%). Dependency on admission (n<!--> <!-->=<!--> <!-->254) vs. 3<!--> <!-->m after hospital discharge (n<!--> <!-->=<!--> <!-->171) vs. 12m after hospital discharge (n<!--> <!-->=<!--> <!-->118): 1) Barthel 90-100: 82% vs. 68% vs. 65%. 2) Barthel 60-85: 15% vs. 15% vs. 20%. 3) Barthel 0-55: 3% vs. 17% vs 15%.</p><p>In the multivariate analysis, adjusted for the variables recorded, we observed that frail patients on admission (CFS-Spain 5-9) are 2.8 times (95%CI: 1.03-7.58; p<!--> <!-->=<!--> <!-->0.043) more likely to increase dependency (Barthel 90-100 to <<!--> <!-->90 or Barthel 85-60 to <<!--> <!-->60) at 3<!--> <!-->m post-discharge (with respect to admission) and 3.5 times (95%CI: 1.18-10.30; p<!--> <!-->=<!--> <!-->0.024) more likely to increase dependency at 12m post-discharge. 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Validez predictiva de la escala de fragilidad Clinical Frailty Scale-España sobre el incremento de la dependencia tras el alta hospitalaria
Introduction
The frailty present at hospital admission and the stressors to which patients are subjected during their stay may increase dependency at hospital discharge.
Objectives
To assess the predictive validity of the Clinical Frailty Scale-Spain (CFS-Spain) on increased dependency at 3 and 12 months (m) after hospital discharge.
Methodology
Multicentre cohort study in 2020-2022. Including patients with > 48 h stay in intensive care units (ICU) and non-COVID-19. Variables: pre-admission frailty (CFS-Spain). Sex, age, days of stay (ICU and hospital), dependency on admission and at 3 m and 12m after discharge (Barthel Index), muscle weakness (Medical Research Council Scale sum score < 48), hospital readmissions. Statistics: descriptive and multivariate analysis.
Results
254 cases were included. Thirty-nine per cent were women and the median [Q1-Q3] age was 67 [56-77] years. SAPS 3 on admission (median [Q1-Q3]): 62 [51-71] points.
Frail patients on admission (CFS-SAPS 5-9): 58 (23%). Dependency on admission (n = 254) vs. 3 m after hospital discharge (n = 171) vs. 12m after hospital discharge (n = 118): 1) Barthel 90-100: 82% vs. 68% vs. 65%. 2) Barthel 60-85: 15% vs. 15% vs. 20%. 3) Barthel 0-55: 3% vs. 17% vs 15%.
In the multivariate analysis, adjusted for the variables recorded, we observed that frail patients on admission (CFS-Spain 5-9) are 2.8 times (95%CI: 1.03-7.58; p = 0.043) more likely to increase dependency (Barthel 90-100 to < 90 or Barthel 85-60 to < 60) at 3 m post-discharge (with respect to admission) and 3.5 times (95%CI: 1.18-10.30; p = 0.024) more likely to increase dependency at 12m post-discharge. Furthermore, for each additional CFS-Spain point there is a 1.6-fold (95%CI: 1.01-2.23; p = 0.016) greater chance of increased dependency in the 12m following discharge.
Conclusions
CFS-Spain at admission can predict increased dependency at 3 m and 12m after hospital discharge.
期刊介绍：
Enfermería Intensiva es el medio de comunicación por antonomasia para todos los profesionales de enfermería españoles que desarrollan su actividad profesional en las unidades de cuidados intensivos o en cualquier otro lugar donde se atiende al paciente crítico. Enfermería Intensiva publica cuatro números al año, cuyos temas son específicos para la enfermería de cuidados intensivos. Es la única publicación en español con carácter nacional y está indexada en prestigiosas bases de datos como International Nursing Index, MEDLINE, Índice de Enfermería, Cuiden, Índice Médico Español, Toxline, etc.
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