AI Article Synopsis
- Patients with COPD are at high risk for frailty and complications during acute exacerbations, prompting this study to evaluate the link between frailty risk and patient outcomes using a nationwide database.
- The study analyzed 3,396 patients with acute COPD exacerbations, comparing low frailty risk and frailty at risk groups, finding that those at higher risk had significantly worse outcomes, including longer hospital stays and higher mortality rates.
- The findings suggest that the Hospital Frailty Risk Score (HFRS) is an effective tool for predicting complications in these patients, supporting its use in clinical settings for managing acute exacerbations of COPD.
Article Abstract
Introduction: Patients with chronic obstructive pulmonary disease (COPD) are at high risk for frailty and prone to complications after admission for an acute exacerbation. We aim to investigate the association between frailty risk and functional outcomes in patients with acute exacerbations of COPD, using a nationwide database.
Methods: This retrospective cohort study included patients with acute exacerbations of COPD who were admitted by ambulance. We assessed frailty using the Hospital Frailty Risk Score (HFRS) and compared the outcomes between low frailty risk (HFRS < 5) and frailty at risk (HFRS ≥ 5) groups. The primary outcome was prolonged hospitalization (≥30 days). The secondary outcomes were in-hospital mortality, readmission (≤90 days), poor activities of daily living (ADL) at discharge, and difficulty in returning home.
Results: There were 3,396 eligible patients (mean age, 75.9 ± 11.2 years; 20.4% female). The rate of frailty at risk patients was 14.0%. Frailty at risk patients were significantly higher rates of prolonged hospitalization (32.9% vs. 17.5%), more in-hospital mortality (16.4% vs. 12.5%), more difficulty in returning home (34.6% vs. 22.9%), and poorer ADL at discharge (8.7% vs. 12.4%) than those of low frailty risk. Multivariate analysis with adjusted covariates showed that HFRS was independently associated with prolonged hospitalization (odds ratio, 2.0; 95% confidence interval, 1.4-2.9).
Conclusions: HFRS can be used to predict the outcome of patients with acute exacerbations of COPD. This finding supports the validity of using the HFRS in clinical practice with patients with acute exacerbations of COPD.
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| http://dx.doi.org/10.1016/j.archger.2022.104658 | DOI Listing |
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