机构:[1]Department of Emergency Medicine, Beijing Chao-Yang Hospital, Capital Medical University, & Beijing Key Laboratory of Cardiopulmonary Cerebral Resuscitation, Beijing, China北京朝阳医院[2]Department of Emergency Medicine, Capital Medical University School of Rehabilitation Medicine, Beijing Bo’Ai Hospital, China Rehabilitation Research Center, Beijing, China[3]Department of Geriatrics, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, China内科系统老年医学科首都医科大学宣武医院
Aim To compare the predictive abilities of the FRAIL scale (FS), frailty screening questionnaire (FSQ) and clinical frailty scale (CFS) for adverse outcomes in older adults in the emergency department. Methods In total, 317 older adults aged >= 65 years attending emergency department was screened for frailty using the FS, FSQ and CFS. Outcome measures included all-cause 28-day mortality and intensive care unit readmission. Cox proportional hazards model was used for survival comparison. Logistic regression was used to analyze risk factors for readmissions. In addition, we calculated the C-statistic, net reclassification improvement and integrated discrimination improvement to evaluate the predictive value of three scales. Results The prevalence of frailty was 55.2% (FS), 47.0% (FSQ) and 69.4% (CFS). Cox regression and logistic regression analysis revealed that frailty screening by FS, FSQ and CFS was an independent risk factor for all-cause 28-day mortality and 30- and 90-day readmission after adjustment. Incorporation of FS, FSQ and CFS into a basic model with other risk factors significantly improved C-statistic. For all-cause 28-day mortality, the model including FS had the highest C-statistic from 0.786 (95% confidence interval: 0.706-0.865) to 0.854 (95% confidence interval: 0.802-0.907) and the improvements in risk prediction were also confirmed by category-free net reclassification improvement and integrated discrimination improvement, suggesting FS was significantly better than CFS and FSQ. The three tools had a low predictive ability for readmission (all C-statistics <0.7). Conclusions All three frailty scales showed a predictive ability for 28-day mortality and readmission but FS may be the most valid tool in the emergency department. Geriatr Gerontol Int center dot center dot; center dot center dot: center dot center dot-center dot center dot Geriatr Gerontol Int 2022; center dot center dot: center dot center dot-center dot center dot.
基金:
Open Project of Beijing Key Laboratory [2020XFN-KFKT-02]
第一作者机构:[1]Department of Emergency Medicine, Beijing Chao-Yang Hospital, Capital Medical University, & Beijing Key Laboratory of Cardiopulmonary Cerebral Resuscitation, Beijing, China[2]Department of Emergency Medicine, Capital Medical University School of Rehabilitation Medicine, Beijing Bo’Ai Hospital, China Rehabilitation Research Center, Beijing, China
共同第一作者:
通讯作者:
通讯机构:[1]Department of Emergency Medicine, Beijing Chao-Yang Hospital, Capital Medical University, & Beijing Key Laboratory of Cardiopulmonary Cerebral Resuscitation, Beijing, China[*1]Department of Emergency Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing Key Laboratory of Cardiopulmonary Cerebral Resuscitation, Beijing 100020, China.
推荐引用方式(GB/T 7714):
Shang Na,Liu Huizhen,Wang Na,et al.Comparison of three frailty screening instruments for prediction of adverse outcomes among older adults in the emergency department[J].GERIATRICS & GERONTOLOGY INTERNATIONAL.2022,22(10):851-856.doi:10.1111/ggi.14469.
APA:
Shang, Na,Liu, Huizhen,Wang, Na,Guo, Shubin&Ma, Lina.(2022).Comparison of three frailty screening instruments for prediction of adverse outcomes among older adults in the emergency department.GERIATRICS & GERONTOLOGY INTERNATIONAL,22,(10)
MLA:
Shang, Na,et al."Comparison of three frailty screening instruments for prediction of adverse outcomes among older adults in the emergency department".GERIATRICS & GERONTOLOGY INTERNATIONAL 22..10(2022):851-856