医学
慢性阻塞性肺病
恶化
优势比
置信区间
内科学
回顾性队列研究
日常生活活动
队列研究
物理疗法
急诊医学
作者
Kenta Ushida,Akio Shimizu,Shinsuke Hori,Yoshinori Yamamoto,Ryo Momosaki
标识
DOI:10.1016/j.archger.2022.104658
摘要
Patients with chronic obstructive pulmonary disease (COPD) are at high risk for frailty and prone to complications after admission for an acute exacerbation. We aim to investigate the association between frailty risk and functional outcomes in patients with acute exacerbations of COPD, using a nationwide database.This retrospective cohort study included patients with acute exacerbations of COPD who were admitted by ambulance. We assessed frailty using the Hospital Frailty Risk Score (HFRS) and compared the outcomes between low frailty risk (HFRS < 5) and frailty at risk (HFRS ≥ 5) groups. The primary outcome was prolonged hospitalization (≥30 days). The secondary outcomes were in-hospital mortality, readmission (≤90 days), poor activities of daily living (ADL) at discharge, and difficulty in returning home.There were 3,396 eligible patients (mean age, 75.9 ± 11.2 years; 20.4% female). The rate of frailty at risk patients was 14.0%. Frailty at risk patients were significantly higher rates of prolonged hospitalization (32.9% vs. 17.5%), more in-hospital mortality (16.4% vs. 12.5%), more difficulty in returning home (34.6% vs. 22.9%), and poorer ADL at discharge (8.7% vs. 12.4%) than those of low frailty risk. Multivariate analysis with adjusted covariates showed that HFRS was independently associated with prolonged hospitalization (odds ratio, 2.0; 95% confidence interval, 1.4-2.9).HFRS can be used to predict the outcome of patients with acute exacerbations of COPD. This finding supports the validity of using the HFRS in clinical practice with patients with acute exacerbations of COPD.
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