衰弱与急诊老年创伤患者不良预后关系的前瞻性队列研究

OBJECTIVE: To explore the relationship between frailty and adverse outcomes in older trauma patients in the emergency department. METHODS: A prospective cohort study was conducted. Older trauma patients admitted to the emergency department of three tertiary-care hospitals in Chengdu between January 2021 and August 2021 were enrolled. The patients were divided into a frailty group and a non-frailty group according to their assessment results for Trauma-Specific Frailty Index (TSFI). The end points, including falls, readmission, and deaths, were documented during the 6-month follow-up. Cox risk regression model was used to analyze the relationship between frailty and adverse outcomes in older trauma patients in the emergency department. RESULTS: A total of 375 older trauma patients in the emergency department were enrolled, including 131 in the frailty group and 244 in the non-frailty group. After 6 months of follow-up, the incidences of falls, readmission and deaths in older trauma patients in the emergency department were 18.93%, 14.40%, and 7.73%, respectively. The incidences of falls (28.24% vs. 13.93%, P=0.001), readmission (25.95% vs. 8.20%, P=0.000), and deaths (12.98% vs. 4.92%, P=0.005) in older trauma patients in the emergency department in the frailty group were higher than those in the non-frailty group. After adjusting for multiple confounding factors using the Cox regression model, the risks of falls (hazard ratio [HR]=1.859, 95% confidence interval [CI]: 1.070-3.230, P=0.028] and readmission (HR=2.920, 95% CI: 1.537-5.547, P=0.001) were higher in the frailty group than those in the non-frailty group, but there was no significant difference in the risk of deaths between the frailty group and the non-frailty group. CONCLUSION: Frailty is a risk factor for falls and readmissions in older trauma patients in the emergency department and the association between frailty and the risk of deaths in older trauma patients in the emergency department needs to be validated by further studies.