改良医院虚弱风险评分（mHFRS）作为识别和预测有虚弱风险的住院老年人结局的工具。

Modified Hospital Frailty Risk Score (mHFRS) as a Tool to Identify and Predict Outcomes for Hospitalised Older Adults at Risk of Frailty.

作者信息

Sim Lydia, Chang Ting Yu, Htin Kyaw Khine, Lim Aileen, Selvaratnam Thevapriya, Conroy Simon, Goh Kiat Sern, Rosario Barbara

机构信息

Health Systems Intelligence, Changi General Hospital, Singapore.

National University of Singapore, Singapore.

出版信息

J Frailty Sarcopenia Falls. 2024 Dec 1;9(4):235-248. doi: 10.22540/JFSF-09-235. eCollection 2024 Dec.

DOI:10.22540/JFSF-09-235

PMID:39635564

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11613971/

Abstract

OBJECTIVES

This study aims to determine whether modified Hospital Frailty Risk Score (mHFRS) can identify frail hospitalised older adults by comparing mHFRS to HFRS and Clinical Frailty Scale (CFS).

METHODS

A retrospective review was undertaken in patients =>65 years hospitalised following an Emergency Department attendance between 1 July 2022 and 31 March 2023. Predictive models were evaluated with correlation and measure of agreement between frailty risk scores, CFS and HFRS, CFS and modified HFRS (mHFRS) using the Spearman's rank correlation and Cohen's kappa (κ).

RESULTS

Of 3042 patients, CFS categorised 1635 (53.7%) patients as non-frail (CFS 1-4) and 1407 (46.3%) as frail (CFS 5-9,p<0.001). Frail patients were more likely to be female (55.9%), older (81.8 years, SD 8.41 vs 75.3 years, SD 7.20, p<0.001), with longer LOS (52.5% % vs 31.5%, p<0.001), higher 30-day emergency re-admission (18.5% vs 9.9%, p<0.001) and higher mortality at all time points. We could compute mHFRS for 1623 (53.4%) patients, of whom, 37.5% were low risk, 40.5% intermediate risk and 22.1% high frailty risk. mHFRS showed significant correlation with CFS (p<0.001) and HFRS (p<0.001), respectively and achieved comparable association with clinical outcomes.

CONCLUSION

mHFRS was better at identifying non-frail patients and provides a novel, standardised and comparable frailty risk stratification tool for screening older hospitalised patients.

摘要

目的

本研究旨在通过比较改良医院虚弱风险评分（mHFRS）与医院虚弱风险评分（HFRS）及临床虚弱量表（CFS），确定mHFRS能否识别住院的老年虚弱患者。

方法

对2022年7月1日至2023年3月31日期间因急诊就诊后住院的65岁及以上患者进行回顾性研究。使用Spearman等级相关性和Cohen's kappa（κ）评估预测模型，分析虚弱风险评分、CFS与HFRS、CFS与改良HFRS（mHFRS）之间的相关性和一致性。

结果

在3042例患者中，CFS将1635例（53.7%）患者分类为非虚弱（CFS 1 - 4），1407例（46.3%）患者分类为虚弱（CFS 5 - 9，p<0.001）。虚弱患者更可能为女性（55.9%），年龄更大（81.8岁，标准差8.41 vs 75.3岁，标准差7.20，p<0.001），住院时间更长（52.5% vs 31.5%，p<0.001），30天急诊再入院率更高（18.5% vs 9.9%，p<0.001），且在所有时间点死亡率更高。我们能够计算1623例（53.4%）患者的mHFRS，其中37.5%为低风险，40.5%为中度风险，22.1%为高虚弱风险。mHFRS分别与CFS（p<0.001）和HFRS（p<0.001）显示出显著相关性，并与临床结局具有相似的关联。