虚弱预测肺栓塞的老年患者的不良结果
Jorge Sinclair De Frías1,2, Lorenzo Olivero1, Abigail Gabela3
1Department of Critical Care Medicine, Mayo Clinic, Jacksonville, Florida, USA.
Geriatrics & gerontology international
|August 15, 2024
概括
虚弱显著影响肺栓塞 (PE) 的老年患者的结果. 使用医院脆弱性风险评分 (HFRS) 评估脆弱性可以预测死亡率并指导改进的患者护理策略.
科学领域:
- 老年医学 老年医学
- 心脏病学 心脏病学
- 关键护理医学 关键护理医学
背景情况:
- 肺栓塞 (PE) 是老年人患病和死亡的重要原因.
- 脆弱性是影响各种患者群体健康结果的新兴因素.
- 脆弱对PE老年患者特异性结果的影响需要进一步阐明.
研究的目的:
- 评估诊断为肺栓塞 (PE) 的老年患者的脆弱性和临床结果之间的关联.
- 评估医院脆弱性风险评分 (HFRS) 在预测这一队列中的死亡率和资源利用率方面的预后能力.
主要方法:
- 国家住院患者样本数据库 (2017-2019年) 的回顾性分析.
- 包括288,070名年龄在65岁以上,初级PE诊断的患者.
- 使用医院脆弱性风险评分 (HFRS) 评估脆弱性,将患者分为低风险,中等风险和高风险组;多变量逻辑回归用于结果分析.
主要成果:
- 该研究确定了288,070名老年PE患者,分为低 (57.6%),中等 (39.9%) 和高 (2.5%) 脆弱风险组.
- 高风险的虚弱患者,通常是患有并发症的女性,死亡率和不良事件明显增加.
- 高频率临床预测表现出良好的死亡率预测能力 (AUC=0.7796) 并与使用先进疗法和重症监护资源的增加有关.
结论:
- 虚弱是肺栓塞的老年人结局的关键决定因素.
- 医院虚弱风险评分 (HFRS) 作为一个有价值的预后工具,为这一群体.
- 将脆弱性评估纳入临床实践可能会加强护理策略,改善老年PE患者的治疗结果.
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