虚弱预测创伤性脑损伤患者的院内死亡:一项回顾性队列研究

IF 2.8 3区 医学 Q1 Pharmacology, Toxicology and Pharmaceutics
Therapeutics and Clinical Risk Management Pub Date : 2024-09-23 eCollection Date: 2024-01-01 DOI:10.2147/TCRM.S475412
Hua Liu, Wenxi Wu, Min Xu, Xiaoyang Ling, Wei Lu, Feng Cheng, Jian Wang
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引用次数: 0

摘要

背景和目的:创伤性脑损伤(TBI)是老年患者的一个严重公共卫生问题,而虚弱与老年患者较高的死亡率有关。本研究旨在评估体弱对创伤性脑损伤患者的预后价值:回顾性收集2018年12月至2020年12月期间江苏大学附属昆山医院和昆山市中医院收治的348例创伤性脑损伤患者的临床数据。采用单变量和多变量逻辑回归分析来确定影响院内死亡率的风险因素,并绘制接收器操作特征曲线(ROC)来评估虚弱指数的判别能力。虚弱程度采用FRAIL量表进行评估,FRAIL代表疲劳、抵抗力、行动能力、疾病和体重减轻,每个项目的评分为0或1:根据 FRIAL 问卷,122 名患者为低度虚弱,226 名患者为高度虚弱。多变量逻辑回归分析表明,高度虚弱是导致创伤性脑损伤患者院内死亡率的一个风险因素:虚弱是老年创伤性脑损伤患者院内死亡的一个重要风险因素,应更多地关注虚弱程度高的患者。临床医生在评估创伤性脑损伤并做出治疗决定时,应考虑患者的虚弱程度。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Frailty Predicts in-Hospital Death in Traumatic Brain Injury Patients: A Retrospective Cohort Study.

Background and aim: Traumatic brain injury (TBI) is a severe public health problem in elderly patients, and frailty is associated with higher mortality rates in older patients. This study aims to assess the prognostic value of frailty in patients with TBI.

Methods: Clinical data from 348 TBI patients treated at Affiliated Kunshan Hospital of Jiangsu University and Kunshan Hospital of Traditional Chinese Medicine between December 2018 and December 2020 were retrospectively collected. Univariate and multivariate logistic regression analyses were used to determine risk factors affecting in-hospital mortality, and receiver operating characteristic (ROC) curves were plotted to assess the discriminatory power of the frailty index. Frailty was assessed using the FRAIL scale, where FRAIL stands for Fatigue, Resistance, Ambulation, Illness, and Loss of weight, with each item scored as 0 or 1.

Results: Using the FRIAL questionnaire, 122 patients had low frailty and 226 had high frailty. Multivariate logistic regression analysis showed that high frailty was a risk factor for in-hospital mortality in TBI patients (P<0.001, OR=2.012 [1.788-2.412]). The proportion of infections occurring in the two groups was statistically different (P=0.015), with severely infected TBI patients being more likely to develop complications. The ROC curve showed an area under the curve for the FRAIL score of 0.845 [0.752-0.938].

Conclusion: Frailty is an important risk factor for in-hospital mortality in elderly TBI patients, and more attention should be paid to patients with high levels of frailty. Clinicians should consider the degree of frailty when assessing TBI and making treatment decisions.

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来源期刊
Therapeutics and Clinical Risk Management
Therapeutics and Clinical Risk Management HEALTH CARE SCIENCES & SERVICES-
CiteScore
5.30
自引率
3.60%
发文量
139
审稿时长
16 weeks
期刊介绍: Therapeutics and Clinical Risk Management is an international, peer-reviewed journal of clinical therapeutics and risk management, focusing on concise rapid reporting of clinical studies in all therapeutic areas, outcomes, safety, and programs for the effective, safe, and sustained use of medicines, therapeutic and surgical interventions in all clinical areas. The journal welcomes submissions covering original research, clinical and epidemiological studies, reviews, guidelines, expert opinion and commentary. The journal will consider case reports but only if they make a valuable and original contribution to the literature. As of 18th March 2019, Therapeutics and Clinical Risk Management will no longer consider meta-analyses for publication. The journal does not accept study protocols, animal-based or cell line-based studies.
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