首页|期刊导航|陆军军医大学学报|多维度衰弱评分预测老年住院患者并发症风险与不良临床结局:一项回顾性队列研究

多维度衰弱评分预测老年住院患者并发症风险与不良临床结局:一项回顾性队列研究OA

Multidimensional frailty score predicts the risk of in-hospital complications and adverse clinical outcomes in elderly hospitalized patients:a retrospective cohort study

中文摘要英文摘要

目的 本研究旨在证明多维度衰弱评分对老年患者住院并发症(in-hospital conplication,IHC)风险及临床结局的预测效能.方法 对2022年5月到2022年9月在陆军军医大学第一附属医院老年医学科住院的136名年龄≥65岁患者的病历资料进行回顾性研究.从病历系统中提取患者的人口学特征和临床结局指标(病情危重、IHC、住院天数和出院转归).从患者入院后72 h的病历记录中提取9个涵盖社会、心理、生理维度的衰弱因素,单个因素阳性计1分,多维度衰弱评分为9个因素的总分.使用IBM SPSS 25.0软件数据分析多维度衰弱评分对患者住院期间病情危重.本研究获得陆军军医大学第一附属医院伦理委员会批准[批件号(B)KY2025245].结果 ①36名(26.4%)患者住院期间发生IHC,发生IHC的患者入院病情危重比例更高、住院时间更长、多维度衰弱评分更高.②多维度衰弱评分预警患者住院期间 IHC 和入院病情危重的 AUC 分别为 0.712(95%CI:0.614~0.810)和 0.738(95%CI:0.644~0.832),最佳预警阈值分别为2分和3分.③多维度衰弱评分较高的患者住院期间发生IHC(β=0.487,OR=1.628,P<0.001)和入院病情危重(β=0.557,OR:1.746,P<0.001)的风险升高;④多维度衰弱评分较高的患者好转出院机率降低(β=-0.602,OR:0.547,P=0.040).结论 多维度衰弱评估操作简便,对老年患者住院期间发生IHC风险和入院病情危重具有较好的预警价值,用于对新入院患者进行快速评估.

Objective To investigate the predictive efficacy of multidimensional frailty assessment scoring for in-hospital complications(IHC)risk and clinical outcomes in elderly inpatients.Methods A retrospective analysis was conducted on 136 elderly patients aged≥65 years who were hospitalized in Department of Geriatrics of First Affiliated Hospital of Army Medical University from May 2022 to September 2022.Demographic characteristics and clinical outcome indicators(critical illness,IHC,length of hospital stay,and discharge outcomes)were extracted from the medical record system.Nine frailty factors,in aspects of social,psychological,and physiological dimensions were identified from medical records within 72 h after admission,and each positive factor scored as 1 point.The multidimensional frailty score was calculated as a total score for all 9 factors.IBM SPSS statistics 23.0 was used for data analysis to evaluate the predictive value of the multidimensional frailty score for critical illness during hospitalization.This study was approved by the Ethics Committee of the First Affiliated Hospital of Army Medical University[approval number(B)KY2025245].Results ① IHC occurred in 36 patients(26.5%)during hospitalization;Those developing IHC had a higher proportion of critical illness on admission,longer hospital stays,and higher multidimensional frailty scores.② The AUC values of the multidimensional frailty score in predicting IHC and critical illness during hospitalization were 0.712(95%CI:0.614 to 0.810)and 0.738(95%CI:0.644 to 0.832),respectively,with optimal cutoff values of 2 and 3 points.③ The patients with higher multidimensional frailty scores had an increased risk for in-hospital IHC(β=0.487,OR=1.628,P<0.001)and critical illness on admission(β=0.557,OR=1.746,P<0.001);④ Conversely,those with elevated frailty scores showed reduced probability of favorable discharge(β=-0.602,OR=0.547,P=0.040).Conclusion Multidimensional frailty assessment is simple to perform and demonstrates good predictive value for the risk of IHC and critical illness on admission in elderly patients,and can be used for rapid assessment of newly admitted patients.

吕慈;王文友;郭道远;全阳;何屹;王笑梅

陆军军医大学(第三军医大学)第一附属医院老年医学与特勤医学科,重庆陆军军医大学(第三军医大学)第一附属医院老年医学与特勤医学科,重庆陆军军医大学(第三军医大学)第一附属医院老年医学与特勤医学科,重庆||陆军军医大学(第三军医大学)第一附属医院江北院区(陆军第九五八医院)骨科,重庆陆军军医大学(第三军医大学)第一附属医院老年医学与特勤医学科,重庆陆军军医大学(第三军医大学)第一附属医院老年医学与特勤医学科,重庆陆军军医大学(第三军医大学)第一附属医院老年医学与特勤医学科,重庆||陆军军医大学(第三军医大学)第一附属医院江北院区(陆军第九五八医院)骨科,重庆

医药卫生

住院并发症临床结局住院时间多维度衰弱心理衰弱

in-hospital complicationsclinical outcomeslength of hospital staymultidimensional frailtypsychological frailty

《陆军军医大学学报》 2026 (12)

1775-1781,7

重庆市科技与民生项目(cstc2018jscx-msyb0580) Supported by the Project of Science and Technology Innovation and People's Livelihood Security of Chongqing(cstc2018jscx-msyb0580).

10.16016/j.2097-0927.202512112

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