Effect Modification by Sex of the Hemoglobin Concentration on Frailty Risk in Hospitalized Older Patients

Qiuping Li, Xi Chen, Binru Han Department of Nursing, Xuanwu Hospital, Capital Medical University, Beijing, People’s Republic of ChinaCorrespondence: Binru HanXuanwu Hospital, Capital Medical University, Chang Chun St.45, Xicheng District, Beijing, 100053, People’s Republic of Ch...

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Autores principales:	Li Q, Chen X, Han B
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2021
Materias:	hemoglobin concentration frailty phenotype older inpatient interaction effect Geriatrics RC952-954.6
Acceso en línea:	https://doaj.org/article/3c5b3db6510d459196d9b0278b6a0486
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spelling	oai:doaj.org-article:3c5b3db6510d459196d9b0278b6a04862021-12-02T18:31:08ZEffect Modification by Sex of the Hemoglobin Concentration on Frailty Risk in Hospitalized Older Patients1178-1998https://doaj.org/article/3c5b3db6510d459196d9b0278b6a04862021-04-01T00:00:00Zhttps://www.dovepress.com/effect-modification-by-sex-of-the-hemoglobin-concentration-on-frailty--peer-reviewed-fulltext-article-CIAhttps://doaj.org/toc/1178-1998Qiuping Li, Xi Chen, Binru Han Department of Nursing, Xuanwu Hospital, Capital Medical University, Beijing, People’s Republic of ChinaCorrespondence: Binru HanXuanwu Hospital, Capital Medical University, Chang Chun St.45, Xicheng District, Beijing, 100053, People’s Republic of ChinaTel +86 10-83198219Fax +86 10-83198258Email kinv246@126.comBackground: Hemoglobin concentration differs by sex, possibly affecting any association between hemoglobin and frailty. This study aimed to evaluate the potential interaction effect of hemoglobin and sex on frailty in Chinese older inpatients.Methods: A cross-sectional study was conducted between February 2015 and November 2017 in a tertiary hospital. Frailty was defined by the Fried phenotype. Hemoglobin concentration was measured with a standard procedure. Covariates included demographics, clinical characteristics, and serum biomarkers. Logistic regression was applied to examine the association between hemoglobin concentration and frailty. The relative excess risk due to interaction (RERI), attributable proportion due to interaction (AP), and synergy index (SI) were used to evaluate the additive interaction.Results: A total of 619 older inpatients [mean age 69.26± 7.44 years; 334 men, 285 women] were included. The mean hemoglobin concentration was significantly lower in the elderly who were frail (11.9 g/L in frail versus 13.1g/L in non-frail; p< 0.001). In the multivariable regression models, lower hemoglobin in patients was significantly associated with frailty (adjusted odds ratio (OR) = 2.51, 95% CI:1.37, 4.60). The stratified analyses indicated that lower hemoglobin was associated with frailty among older inpatients with different characteristics. Female inpatients with lower hemoglobin had the highest risk of frailty (adjusted OR=6.43, 95%: 2.38, 17.3); there were interactions between hemoglobin and sex on the development of frailty (RERI=4.30, 95% CI=− 1.41, 10.01; AP=0.67, 95% CI=0.37, 0.97;SI=4.80, 95% CI=1.22, 18.84).Conclusions and Implications: Our study provided evidence that sex and lower hemoglobin have an interaction effect on frailty; it is suggested that clinicians may consider sex-specific strategies for the elderly to conform the concept of precision medicine.Keywords: hemoglobin concentration, frailty phenotype, older inpatient, interaction effectLi QChen XHan BDove Medical Pressarticlehemoglobin concentrationfrailty phenotypeolder inpatientinteraction effectGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 16, Pp 687-696 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	hemoglobin concentration frailty phenotype older inpatient interaction effect Geriatrics RC952-954.6
spellingShingle	hemoglobin concentration frailty phenotype older inpatient interaction effect Geriatrics RC952-954.6 Li Q Chen X Han B Effect Modification by Sex of the Hemoglobin Concentration on Frailty Risk in Hospitalized Older Patients
description	Qiuping Li, Xi Chen, Binru Han Department of Nursing, Xuanwu Hospital, Capital Medical University, Beijing, People’s Republic of ChinaCorrespondence: Binru HanXuanwu Hospital, Capital Medical University, Chang Chun St.45, Xicheng District, Beijing, 100053, People’s Republic of ChinaTel +86 10-83198219Fax +86 10-83198258Email kinv246@126.comBackground: Hemoglobin concentration differs by sex, possibly affecting any association between hemoglobin and frailty. This study aimed to evaluate the potential interaction effect of hemoglobin and sex on frailty in Chinese older inpatients.Methods: A cross-sectional study was conducted between February 2015 and November 2017 in a tertiary hospital. Frailty was defined by the Fried phenotype. Hemoglobin concentration was measured with a standard procedure. Covariates included demographics, clinical characteristics, and serum biomarkers. Logistic regression was applied to examine the association between hemoglobin concentration and frailty. The relative excess risk due to interaction (RERI), attributable proportion due to interaction (AP), and synergy index (SI) were used to evaluate the additive interaction.Results: A total of 619 older inpatients [mean age 69.26± 7.44 years; 334 men, 285 women] were included. The mean hemoglobin concentration was significantly lower in the elderly who were frail (11.9 g/L in frail versus 13.1g/L in non-frail; p< 0.001). In the multivariable regression models, lower hemoglobin in patients was significantly associated with frailty (adjusted odds ratio (OR) = 2.51, 95% CI:1.37, 4.60). The stratified analyses indicated that lower hemoglobin was associated with frailty among older inpatients with different characteristics. Female inpatients with lower hemoglobin had the highest risk of frailty (adjusted OR=6.43, 95%: 2.38, 17.3); there were interactions between hemoglobin and sex on the development of frailty (RERI=4.30, 95% CI=− 1.41, 10.01; AP=0.67, 95% CI=0.37, 0.97;SI=4.80, 95% CI=1.22, 18.84).Conclusions and Implications: Our study provided evidence that sex and lower hemoglobin have an interaction effect on frailty; it is suggested that clinicians may consider sex-specific strategies for the elderly to conform the concept of precision medicine.Keywords: hemoglobin concentration, frailty phenotype, older inpatient, interaction effect
format	article
author	Li Q Chen X Han B
author_facet	Li Q Chen X Han B
author_sort	Li Q
title	Effect Modification by Sex of the Hemoglobin Concentration on Frailty Risk in Hospitalized Older Patients
title_short	Effect Modification by Sex of the Hemoglobin Concentration on Frailty Risk in Hospitalized Older Patients
title_full	Effect Modification by Sex of the Hemoglobin Concentration on Frailty Risk in Hospitalized Older Patients
title_fullStr	Effect Modification by Sex of the Hemoglobin Concentration on Frailty Risk in Hospitalized Older Patients
title_full_unstemmed	Effect Modification by Sex of the Hemoglobin Concentration on Frailty Risk in Hospitalized Older Patients
title_sort	effect modification by sex of the hemoglobin concentration on frailty risk in hospitalized older patients
publisher	Dove Medical Press
publishDate	2021
url	https://doaj.org/article/3c5b3db6510d459196d9b0278b6a0486
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_version_	1718377970563809280

Effect Modification by Sex of the Hemoglobin Concentration on Frailty Risk in Hospitalized Older Patients

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