Identification of Frailty and Its Risk Factors in Elderly Hospitalized Patients from Different Wards: A Cross-Sectional Study in China

Identification of Frailty and Its Risk Factors in Elderly Hospitalized Patients from Different Wards: A Cross-Sectional Study in China

Yao-Dan Liang,1,2 Yao-Nan Zhang,3 Yan-Ming Li,4 Yu-Hui Chen,5 Jing-Yong Xu,6 Ming Liu,7 Jing Li,8 Zhao Ma,9 Lin-Lin Qiao,10 Zi Wang,11 Jie-Fu Yang,1 Hua Wang1 1Department of Cardiology, Beijing Hospital, National Center of Gerontology, Beijing, People’s Republic of China; 2Chinese Academy...

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Autores principales: Liang YD, Zhang YN, Li YM, Chen YH, Xu JY, Liu M, Li J, Ma Z, Qiao LL, Wang Z, Yang JF, Wang H
Formato: article
Lenguaje:EN
Publicado: Dove Medical Press 2019
Materias:
frailty
elderly hospitalized patients
wards
risk factor
china
Geriatrics
RC952-954.6
Acceso en línea:https://doaj.org/article/c5cc9fd26dea46b780b85e2f9f080071
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spelling oai:doaj.org-article:c5cc9fd26dea46b780b85e2f9f0800712021-12-02T05:04:50ZIdentification of Frailty and Its Risk Factors in Elderly Hospitalized Patients from Different Wards: A Cross-Sectional Study in China1178-1998https://doaj.org/article/c5cc9fd26dea46b780b85e2f9f0800712019-12-01T00:00:00Zhttps://www.dovepress.com/identification-of-frailty-and-its-risk-factors-in-elderly-hospitalized-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Yao-Dan Liang,1,2 Yao-Nan Zhang,3 Yan-Ming Li,4 Yu-Hui Chen,5 Jing-Yong Xu,6 Ming Liu,7 Jing Li,8 Zhao Ma,9 Lin-Lin Qiao,10 Zi Wang,11 Jie-Fu Yang,1 Hua Wang1 1Department of Cardiology, Beijing Hospital, National Center of Gerontology, Beijing, People’s Republic of China; 2Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, People’s Republic of China; 3Department of Orthopedics; 4Department of Pulmonary and Critical Care Medicine; 5Department of Neurology; 6Department of General Surgery; 7Department of Urology; 8Department of Geriatrics; 9Department of Rehabilitation; 10Department of Traditional Chinese Medicine; 11Department of Cardiac Surgery, Beijing Hospital, National Center of Gerontology, Beijing, People’s Republic of ChinaCorrespondence: Hua Wang; Jie-Fu YangDepartment of Cardiology, Beijing Hospital, National Center of Gerontology, No. 1, Dahua Road, Dongcheng District, Beijing 100730, People’s Republic of ChinaTel +86 13911680467; +86 13601292259Fax +86-010-58115035Email wh74220@aliyun.com; yangjiefu2011@126.comObjectives: To survey the difference of frailty prevalence in elderly inpatients amongdifferent wards; to compare the diagnostic performance of five frailty measurements (Clinical Frailty Scale [CFS], FRAIL, Fried, Edmonton, Frailty Index [FI]) in identifying frailty; and to explore the risk factors of frailty in elderly inpatients.Participants and methods: This was a cross-sectional study including 1000 inpatients (mean age 75.2±6.7 years, 51.5% male; 542, 229, and 229 patients from cardiology, non-surgical, and surgical wards, respectively) in a tertiary hospital from September 2018 to February 2019. We applied the combined index to integrate the five frailty measurements mentioned above as the gold standard of frailty diagnosis. Multivariate logistic regression models were used to determine the independent risk factors of frailty.Results: Frailty prevalence was 32.3% (Fried), 36.2% (CFS), 19.2% (FRAIL), 25.2% (Edmonton), 35.1% (FI) in all patients. The frailty was more common in non-surgical wards, regardless of the frailty assessment tools used (non-surgical wards: 27.5% to 51.5%; cardiology ward: 14.9% to 29.3%; surgical wards: 18.8% to 41.9%). CFS≥5 showed a sensitivity of 94.1% and a specificity of 85.2% for all patients. FI≥0.25 showed a sensitivity of 94.8% and a specificity of 87.0% for all patients. Age [odds ratio (OR) = 1.089, P<0.001], education level (OR = 0.782, P=0.001), heart rate (OR = 1.025, P<0.001), albumin (OR = 0.911, P=0.002), log D-dimer (OR = 2.940, P<0.001), ≥5 comorbidities (OR = 2.164, P=0.002), and ≥5 medications (OR = 2.819, P<0.001) were independently associated with frailty in all participants.Conclusion: Frailty is common among elderly inpatients, especially in non-surgical wards. CFS is a preferred screening tool and FI may be an optimal assessment tool. Old age, low educational level, fast heart rate, low albumin, high D-dimer, ≥5 comorbidities, and polypharmacy are independent risk factors of frailty in elderly hospitalized patients.Keywords: frailty, elderly hospitalized patients, wards, risk factor, ChinaLiang YDZhang YNLi YMChen YHXu JYLiu MLi JMa ZQiao LLWang ZYang JFWang HDove Medical Pressarticlefrailtyelderly hospitalized patientswardsrisk factorchinaGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 14, Pp 2249-2259 (2019)
institution DOAJ
collection DOAJ
language EN
topic frailty
elderly hospitalized patients
wards
risk factor
china
Geriatrics
RC952-954.6
spellingShingle frailty
elderly hospitalized patients
wards
risk factor
china
Geriatrics
RC952-954.6
Liang YD
Zhang YN
Li YM
Chen YH
Xu JY
Liu M
Li J
Ma Z
Qiao LL
Wang Z
Yang JF
Wang H
Identification of Frailty and Its Risk Factors in Elderly Hospitalized Patients from Different Wards: A Cross-Sectional Study in China
description Yao-Dan Liang,1,2 Yao-Nan Zhang,3 Yan-Ming Li,4 Yu-Hui Chen,5 Jing-Yong Xu,6 Ming Liu,7 Jing Li,8 Zhao Ma,9 Lin-Lin Qiao,10 Zi Wang,11 Jie-Fu Yang,1 Hua Wang1 1Department of Cardiology, Beijing Hospital, National Center of Gerontology, Beijing, People’s Republic of China; 2Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, People’s Republic of China; 3Department of Orthopedics; 4Department of Pulmonary and Critical Care Medicine; 5Department of Neurology; 6Department of General Surgery; 7Department of Urology; 8Department of Geriatrics; 9Department of Rehabilitation; 10Department of Traditional Chinese Medicine; 11Department of Cardiac Surgery, Beijing Hospital, National Center of Gerontology, Beijing, People’s Republic of ChinaCorrespondence: Hua Wang; Jie-Fu YangDepartment of Cardiology, Beijing Hospital, National Center of Gerontology, No. 1, Dahua Road, Dongcheng District, Beijing 100730, People’s Republic of ChinaTel +86 13911680467; +86 13601292259Fax +86-010-58115035Email wh74220@aliyun.com; yangjiefu2011@126.comObjectives: To survey the difference of frailty prevalence in elderly inpatients amongdifferent wards; to compare the diagnostic performance of five frailty measurements (Clinical Frailty Scale [CFS], FRAIL, Fried, Edmonton, Frailty Index [FI]) in identifying frailty; and to explore the risk factors of frailty in elderly inpatients.Participants and methods: This was a cross-sectional study including 1000 inpatients (mean age 75.2±6.7 years, 51.5% male; 542, 229, and 229 patients from cardiology, non-surgical, and surgical wards, respectively) in a tertiary hospital from September 2018 to February 2019. We applied the combined index to integrate the five frailty measurements mentioned above as the gold standard of frailty diagnosis. Multivariate logistic regression models were used to determine the independent risk factors of frailty.Results: Frailty prevalence was 32.3% (Fried), 36.2% (CFS), 19.2% (FRAIL), 25.2% (Edmonton), 35.1% (FI) in all patients. The frailty was more common in non-surgical wards, regardless of the frailty assessment tools used (non-surgical wards: 27.5% to 51.5%; cardiology ward: 14.9% to 29.3%; surgical wards: 18.8% to 41.9%). CFS≥5 showed a sensitivity of 94.1% and a specificity of 85.2% for all patients. FI≥0.25 showed a sensitivity of 94.8% and a specificity of 87.0% for all patients. Age [odds ratio (OR) = 1.089, P<0.001], education level (OR = 0.782, P=0.001), heart rate (OR = 1.025, P<0.001), albumin (OR = 0.911, P=0.002), log D-dimer (OR = 2.940, P<0.001), ≥5 comorbidities (OR = 2.164, P=0.002), and ≥5 medications (OR = 2.819, P<0.001) were independently associated with frailty in all participants.Conclusion: Frailty is common among elderly inpatients, especially in non-surgical wards. CFS is a preferred screening tool and FI may be an optimal assessment tool. Old age, low educational level, fast heart rate, low albumin, high D-dimer, ≥5 comorbidities, and polypharmacy are independent risk factors of frailty in elderly hospitalized patients.Keywords: frailty, elderly hospitalized patients, wards, risk factor, China
format article
author Liang YD
Zhang YN
Li YM
Chen YH
Xu JY
Liu M
Li J
Ma Z
Qiao LL
Wang Z
Yang JF
Wang H
author_facet Liang YD
Zhang YN
Li YM
Chen YH
Xu JY
Liu M
Li J
Ma Z
Qiao LL
Wang Z
Yang JF
Wang H
author_sort Liang YD
title Identification of Frailty and Its Risk Factors in Elderly Hospitalized Patients from Different Wards: A Cross-Sectional Study in China
title_short Identification of Frailty and Its Risk Factors in Elderly Hospitalized Patients from Different Wards: A Cross-Sectional Study in China
title_full Identification of Frailty and Its Risk Factors in Elderly Hospitalized Patients from Different Wards: A Cross-Sectional Study in China
title_fullStr Identification of Frailty and Its Risk Factors in Elderly Hospitalized Patients from Different Wards: A Cross-Sectional Study in China
title_full_unstemmed Identification of Frailty and Its Risk Factors in Elderly Hospitalized Patients from Different Wards: A Cross-Sectional Study in China
title_sort identification of frailty and its risk factors in elderly hospitalized patients from different wards: a cross-sectional study in china
publisher Dove Medical Press
publishDate 2019
url https://doaj.org/article/c5cc9fd26dea46b780b85e2f9f080071
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