衰弱会阻碍老年人从流感和急性呼吸道疾病中康复。
Frailty Hinders Recovery From Influenza and Acute Respiratory Illness in Older Adults.
机构信息
Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
Geriatric Medicine Research, Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
出版信息
J Infect Dis. 2020 Jul 6;222(3):428-437. doi: 10.1093/infdis/jiaa092.
BACKGROUND
We examined frailty as a predictor of recovery in older adults hospitalized with influenza and acute respiratory illness.
METHODS
A total of 5011 patients aged ≥65 years were admitted to Canadian Serious Outcomes Surveillance Network hospitals during the 2011/2012, 2012/2013, and 2013/2014 influenza seasons. Frailty was measured using a previously validated frailty index (FI). Poor recovery was defined as death by 30 days postdischarge or an increase of more than 0.06 (≥2 persistent new health deficits) on the FI. Multivariable logistic regression controlled for age, sex, season, influenza diagnosis, and influenza vaccination status.
RESULTS
Mean age was 79.4 (standard deviation = 8.4) years; 53.1% were women. At baseline, 15.0% (n = 750) were nonfrail, 39.3% (n = 1971) were prefrail, 39.8% (n = 1995) were frail, and 5.9% (n = 295) were most frail. Poor recovery was experienced by 21.4%, 52.0% of whom had died. Frailty was associated with lower odds of recovery in all 3 seasons: 2011/2012 (odds ratio [OR] = 0.70; 95% confidence interval [CI], 0.59-0.84), 2012/2013 (OR = 0.72; 95% CI, 0.66-0.79), and 2013/2014 (OR = 0.75; 95% CI, 0.69-0.82); results varied by season, influenza status, vaccination status, and age.
CONCLUSIONS
Increasing frailty is associated with lower odds of recovery, and persistent worsening frailty is an important adverse outcome of acute illness.
背景
我们研究了衰弱作为预测老年人因流感和急性呼吸道疾病住院后恢复情况的指标。
方法
2011/2012、2012/2013 和 2013/2014 流感季节期间，共有 5011 名年龄≥65 岁的患者入住加拿大严重后果监测网络医院。使用先前验证的衰弱指数（FI）测量衰弱。恢复不良定义为出院后 30 天内死亡或 FI 增加超过 0.06（≥2 个持续新健康缺陷）。多变量逻辑回归控制了年龄、性别、季节、流感诊断和流感疫苗接种状况。
结果
平均年龄为 79.4 岁（标准差=8.4）；53.1%为女性。基线时，15.0%（n=750）为非衰弱，39.3%（n=1971）为衰弱前期，39.8%（n=1995）为衰弱，5.9%（n=295）为最衰弱。在所有 3 个季节中，恢复不良的比例为 21.4%，其中 52.0%死亡。在所有 3 个季节中，衰弱与恢复不良的可能性降低相关：2011/2012 年（比值比[OR] = 0.70；95%置信区间[CI]，0.59-0.84）、2012/2013 年（OR = 0.72；95% CI，0.66-0.79）和 2013/2014 年（OR = 0.75；95% CI，0.69-0.82）；结果因季节、流感状态、疫苗接种状态和年龄而异。
结论
衰弱程度增加与恢复可能性降低相关，衰弱持续恶化是急性疾病的重要不良结局。
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