Mortality Risks after Two Years in Frail and Pre-Frail Older Adults Admitted to Hospital.
frail
frailty
fried frailty scale
mortality
pre-frail
survival
Journal
Journal of clinical medicine
ISSN: 2077-0383
Titre abrégé: J Clin Med
Pays: Switzerland
ID NLM: 101606588
Informations de publication
Date de publication:
24 Apr 2023
24 Apr 2023
Historique:
received:
08
01
2023
revised:
11
03
2023
accepted:
06
04
2023
medline:
13
5
2023
pubmed:
13
5
2023
entrez:
13
5
2023
Statut:
epublish
Résumé
Frailty is characterized by a progressive decline in the physiological functions of multiple body systems that lead to a more vulnerable condition, which is prone to the development of various adverse events, such as falls, hospitalization, and mortality. This study aims to determine whether frailty increases mortality compared to pre-frailty and to identify variables associated with a higher risk of mortality. Two cohorts, frail and pre-frail subjects, are evaluated according to the Fried phenotype. A complete examination of frailty, cognitive status, comorbidities and pharmacology was carried out at hospital admission and was extracted through electronic health record (EHR). Mortality was evaluated from the EHR. Kaplan-Meier estimates of survival probability functions were calculated at two years censoring time for frail and pre-frail cohorts. The log-rank test assessed significant differences between survival probability functions. Significant variables for frailty ( Frailty is associated with greater mortality at two years censoring time than pre-frailty (log-rank test, Frailty is associated with higher mortality at two years than pre-frailty. Frailty is recognized as a systemic syndrome with many links to older-age comorbidities, which are also found in our study. Polypharmacy is strongly associated with frailty, and several commonly prescribed drugs are strongly associated with increased mortality. It must be considered that frail patients need coordinated attention where the diverse specialist taking care of them jointly examines the interactions between the diversity of treatments prescribed.
Sections du résumé
BACKGROUND
BACKGROUND
Frailty is characterized by a progressive decline in the physiological functions of multiple body systems that lead to a more vulnerable condition, which is prone to the development of various adverse events, such as falls, hospitalization, and mortality. This study aims to determine whether frailty increases mortality compared to pre-frailty and to identify variables associated with a higher risk of mortality.
MATERIALS
METHODS
Two cohorts, frail and pre-frail subjects, are evaluated according to the Fried phenotype. A complete examination of frailty, cognitive status, comorbidities and pharmacology was carried out at hospital admission and was extracted through electronic health record (EHR). Mortality was evaluated from the EHR.
METHODS
METHODS
Kaplan-Meier estimates of survival probability functions were calculated at two years censoring time for frail and pre-frail cohorts. The log-rank test assessed significant differences between survival probability functions. Significant variables for frailty (
RESULTS
RESULTS
Frailty is associated with greater mortality at two years censoring time than pre-frailty (log-rank test,
CONCLUSIONS
CONCLUSIONS
Frailty is associated with higher mortality at two years than pre-frailty. Frailty is recognized as a systemic syndrome with many links to older-age comorbidities, which are also found in our study. Polypharmacy is strongly associated with frailty, and several commonly prescribed drugs are strongly associated with increased mortality. It must be considered that frail patients need coordinated attention where the diverse specialist taking care of them jointly examines the interactions between the diversity of treatments prescribed.
Identifiants
pubmed: 37176544
pii: jcm12093103
doi: 10.3390/jcm12093103
pmc: PMC10179017
pii:
doi:
Types de publication
Journal Article
Langues
eng
Subventions
Organisme : Basque Government
ID : 2016111138
Organisme : Basque Government
ID : KK-2022/00051
Organisme : Basque Government
ID : KK-2021/00070
Organisme : Basque Government
ID : IT1689-22
Organisme : Ministry of Economy, Industry and Competitiveness
ID : PID2020-116346GB-I00
Références
Intern Med J. 2022 May;52(5):724-739
pubmed: 35066970
Thorax. 2020 Aug;75(8):669-678
pubmed: 32376733
J Am Geriatr Soc. 2012 Aug;60(8):1487-92
pubmed: 22881367
Geriatr Nurs. 2022 Jul-Aug;46:62-68
pubmed: 35609433
J Am Geriatr Soc. 1975 Oct;23(10):433-41
pubmed: 1159263
ESC Heart Fail. 2020 Dec;7(6):3427-3437
pubmed: 32955168
Lancet. 2013 Mar 2;381(9868):752-62
pubmed: 23395245
Int J Environ Res Public Health. 2021 Feb 15;18(4):
pubmed: 33672064
Md State Med J. 1965 Feb;14:61-5
pubmed: 14258950
Curr Opin Clin Nutr Metab Care. 2019 Jan;22(1):52-57
pubmed: 30394893
BMC Geriatr. 2010 Jun 09;10:36
pubmed: 20534132
Clin Interv Aging. 2021 Sep 15;16:1659-1667
pubmed: 34552324
J Gen Intern Med. 2022 Nov;37(14):3554-3561
pubmed: 34981346
Geroscience. 2017 Aug;39(4):447-455
pubmed: 28866737
Age Ageing. 2018 Mar 01;47(2):233-241
pubmed: 29036424
Curr Opin Microbiol. 2016 Feb;29:63-7
pubmed: 26673958
Age Ageing. 2020 Oct 23;49(6):915-922
pubmed: 32778870
BMJ Open. 2019 May 14;9(5):e026171
pubmed: 31092652
J Am Med Dir Assoc. 2013 Jun;14(6):437-42
pubmed: 23510827
J Am Med Dir Assoc. 2016 Dec 1;17(12):1163.e1-1163.e17
pubmed: 27886869
Age Ageing. 2018 Mar 1;47(2):193-200
pubmed: 29040347
PLoS One. 2016 Aug 30;11(8):e0161942
pubmed: 27575043
Age Ageing. 2022 Feb 2;51(2):
pubmed: 35165691
Sci Rep. 2022 Aug 19;12(1):14139
pubmed: 35986045
JAMA. 2005 Oct 19;294(15):1934-43
pubmed: 16234500
CMAJ. 2005 Aug 30;173(5):489-95
pubmed: 16129869
PLoS One. 2019 Apr 29;14(4):e0216166
pubmed: 31034516
Age Ageing. 1997 Jul;26(4):315-8
pubmed: 9271296
Age Ageing. 2021 May 5;50(3):631-640
pubmed: 33951156
BMC Geriatr. 2019 Aug 15;19(1):222
pubmed: 31416442
J Gerontol A Biol Sci Med Sci. 2021 Aug 13;76(9):1619-1626
pubmed: 33103718
Clin Interv Aging. 2022 Mar 15;17:265-275
pubmed: 35313671
J Am Geriatr Soc. 2021 Sep;69(9):2419-2429
pubmed: 34048599
Gerontology. 2015;61(4):301-9
pubmed: 25502492
J Geriatr Cardiol. 2019 Feb;16(2):103-113
pubmed: 30923541
Eur Geriatr Med. 2022 Aug;13(4):933-939
pubmed: 35661341
Appl Physiol Nutr Metab. 2017 May;42(5):449-458
pubmed: 28322060
Intensive Care Med. 2017 Aug;43(8):1105-1122
pubmed: 28676896
J Am Heart Assoc. 2021 Sep 7;10(17):e019954
pubmed: 34472374
Int J Med Sci. 2021 Jul 25;18(14):3309-3317
pubmed: 34400900
J Gerontol A Biol Sci Med Sci. 2020 Jan 20;75(2):366-373
pubmed: 30789659
Cochrane Database Syst Rev. 2016 Jan 13;(1):CD011145
pubmed: 26760674
Per Med. 2011 Nov;8(6):681-688
pubmed: 22754581
Br J Hosp Med (Lond). 2019 Nov 2;80(11):642-646
pubmed: 31707885
Eur J Surg Oncol. 2022 Apr;48(4):903-908
pubmed: 34756761
J Chronic Dis. 1987;40(5):373-83
pubmed: 3558716
BMC Med. 2016 Dec 22;14(1):215
pubmed: 28003033
J Gerontol A Biol Sci Med Sci. 2020 Sep 25;75(10):1935-1942
pubmed: 31956891
Mech Ageing Dev. 2021 Sep;198:111546
pubmed: 34324923
Cancer. 2022 Aug 1;128(15):2978-2987
pubmed: 35608563
Age Ageing. 2021 May 5;50(3):608-616
pubmed: 33951151
Arch Neurol. 2008 Jul;65(7):963-7
pubmed: 18625866
Biol Res Nurs. 2022 Apr;24(2):186-201
pubmed: 34967685
Nutr Hosp. 2019 Jul 01;36(Spec No2):26-37
pubmed: 31189322
Vnitr Lek. 2018 Winter;64(11):1076-1083
pubmed: 30606025
J Gerontol. 1994 Mar;49(2):M85-94
pubmed: 8126356
J Clin Psychiatry. 2021 Mar 30;82(3):
pubmed: 34000109
J Am Heart Assoc. 2018 Dec 4;7(23):e008251
pubmed: 30571603
Dig Dis Sci. 2021 Dec;66(12):4178-4190
pubmed: 33385264
Syst Rev. 2022 Sep 2;11(1):187
pubmed: 36056441
Age Ageing. 2014 Jan;43(1):10-2
pubmed: 24132852
Int J Cardiol. 2020 Mar 1;302:30-33
pubmed: 31924393
Ghana Med J. 2019 Sep;53(3):210-216
pubmed: 31741493
BMC Geriatr. 2020 Dec 3;20(1):526
pubmed: 33272208
J Cardiovasc Nurs. 2012 Mar-Apr;27(2):120-31
pubmed: 22334147
J Clin Sleep Med. 2018 Oct 15;14(10):1669-1677
pubmed: 30353805
J Nutr Health Aging. 2009 Nov;13(9):782-8
pubmed: 19812868
BMC Geriatr. 2017 Oct 10;17(1):230
pubmed: 29017448
Age Ageing. 1981 Aug;10(3):141-6
pubmed: 7270321
Panminerva Med. 2022 Mar;64(1):24-30
pubmed: 34761887
Lancet. 2019 Oct 12;394(10206):1365-1375
pubmed: 31609228
BMC Med. 2018 Oct 26;16(1):188
pubmed: 30360759
Exp Gerontol. 2022 Feb;158:111658
pubmed: 34920013
J Frailty Aging. 2021;10(4):327-333
pubmed: 34549246
Nutrition. 1999 Feb;15(2):116-22
pubmed: 9990575
Eur Geriatr Med. 2022 Oct;13(5):1149-1157
pubmed: 35750959
Heart Fail Clin. 2017 Jul;13(3):417-426
pubmed: 28602363
Exp Gerontol. 2019 Oct 15;126:110692
pubmed: 31421185
Eur Geriatr Med. 2020 Oct;11(5):851-855
pubmed: 32683576
J Am Med Dir Assoc. 2022 Jan;23(1):182-185.e13
pubmed: 34582780
J Intern Med. 2021 Nov;290(5):1071-1082
pubmed: 34437740
Int J Nurs Stud. 2015 Aug;52(8):1362-74
pubmed: 25986959
J Gerontol A Biol Sci Med Sci. 2007 Jan;62(1):79-82
pubmed: 17301042
BMJ. 2019 May 29;365:l1580
pubmed: 31147311
J Gerontol A Biol Sci Med Sci. 2001 Mar;56(3):M146-56
pubmed: 11253156
J Frailty Aging. 2021;10(4):320-326
pubmed: 34549245
Postgrad Med. 2019 May;131(4):241-250
pubmed: 30724638
J Gerontol A Biol Sci Med Sci. 2008 Sep;63(9):984-90
pubmed: 18840805
BMC Geriatr. 2019 Jul 11;19(1):184
pubmed: 31291884
Am Surg. 2021 Sep;87(9):1420-1425
pubmed: 33377791
Otolaryngol Head Neck Surg. 2010 Sep;143(3):331-6
pubmed: 20723767
ANZ J Surg. 2021 Mar;91(3):335-340
pubmed: 33021042
JBI Database System Rev Implement Rep. 2018 Jan;16(1):140-232
pubmed: 29324562
J Am Geriatr Soc. 2021 Apr;69(4):908-915
pubmed: 33368158
Crit Care. 2017 Dec 28;21(Suppl 3):308
pubmed: 29297391
Curr Psychiatry Rep. 2013 Jun;15(6):365
pubmed: 23636988
Int Psychogeriatr. 2021 Aug;33(8):803-812
pubmed: 33077009
Int J Qual Stud Health Well-being. 2015 Jun 01;10:27370
pubmed: 26037333
J Am Geriatr Soc. 2021 Apr;69(4):1057-1062
pubmed: 33377190
J Am Geriatr Soc. 1987 May;35(5):412-6
pubmed: 3571790
Hypertension. 2022 Jan;79(1):24-32
pubmed: 34689594
Ann Nutr Metab. 2008;52 Suppl 1:6-11
pubmed: 18382070
Lancet Public Health. 2018 Jul;3(7):e323-e332
pubmed: 29908859
Ann Vasc Surg. 2022 Oct;86:295-304
pubmed: 35533807
Ageing Res Rev. 2020 Jul;60:101047
pubmed: 32171786
Age Ageing. 2022 Mar 1;51(3):
pubmed: 35352795
Arch Gerontol Geriatr. 2022 May-Jun;100:104646
pubmed: 35183986
Rev Med Liege. 2012 Jan;67(1):26-34
pubmed: 22420100
Eur J Trauma Emerg Surg. 2022 Oct;48(5):3855-3862
pubmed: 34741180
Lancet. 2019 Oct 12;394(10206):1376-1386
pubmed: 31609229