出院时衰弱状态与老年脓毒症幸存者90 d内非计划再入院的相关性研究

doi:10.3969/j.issn.1003-9198.2022.07.007

Abstract

Abstract: Objective To investigate the correlation between different frailty status at discharge and unplanned readmission within 90 days after discharge in the elderly survivors from sepsis. Methods A total of 331 elderly survivors from sepsis admitted to the Second Affiliated Hospital of Hainan Medical University from January 2020 to June 2021 were enrolled as the prospective follow-up cohort. The follow-up was carried out consecutively for 90 days, and the observation ended at the first unplanned readmission or completion of follow-up. Based on whether unplanned readmission occurred within 90 days after discharge, the elderly survivors from sepsis were divided into readmission group (n=107) and non-readmission group (n=224). According to the frailty status at discharge, the elderly patients were divided into non-frailty group (n=150), pre-frailty group (n=141) and frailty group (n=40). The clinical data of all the patients were collected. Univariate analysis, Kaplan-Meier curve analysis, multivariate Cox risk proportional regression were used to explore the correlation between frailty status at discharge and unplanned readmission within 90 days after discharge. Results The age, body mass index (BMI), Sequential Organ Failure Assessment (SOFA) score, and the proportion of cerebrovascular disease, pre-frailty and frailty in readmission group were significantly higher than those in non-readmission group (P＜0.05). The accumulated incidence of unplanned readmission within 90 days after discharge increased with the increase of frailty status in the elderly survivors from sepsis (P_trend<0.001). Kaplan-Meier curve analysis showed that the difference of accumulated incidence of unplanned readmission within 90 days after discharge were statistically significant among the patients with different frailty status (χ²=80.800, P<0.001). Taking the non-frail group as the reference, multivariate Cox risk proportional regression showed that after adjusting for age and other related indicators, pre-frailty (HR=2.008, 95%CI:1.225-3.291, P<0.05) and frailty (HR=6.419, 95%CI:3.416-12.061, P<0.05) were the influencing factors of unplanned readmission within 90 days after discharge in the elderly survivors from sepsis. Conclusions The frailty status shows significant influence on unplanned readmission within 90 days after discharge in the elderly survivors from sepsis at a degree-dependent manner.

Key words: aged, sepsis, frailty, unplanned readmission, influcing factor

CLC Number:

R592
R631

CHEN Yu-lin, LI Fen, XING Bo. Correlation between frailty status at discharge and unplanned readmission within 90 days in elderly survivor from sepsis[J]. Practical Geriatrics, 2022, 36(7): 675-679.

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Correlation between frailty status at discharge and unplanned readmission within 90 days in elderly survivor from sepsis

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