Impact of Frailty on the Risk of Exacerbations and All-Cause Mortality in Elderly Patients with Stable Chronic Obstructive Pulmonary Disease
Autor: | Wen Qin Tang, Dai Zhang, Ying Ying Sun, Jia Ning Luo, Li-Yang Dou |
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Jazyk: | angličtina |
Rok vydání: | 2021 |
Předmět: |
Male
Weakness medicine.medical_specialty Exacerbation Frail Elderly Pulmonary disease frailty 03 medical and health sciences symbols.namesake Pulmonary Disease Chronic Obstructive 0302 clinical medicine Weight loss Internal medicine medicine Prevalence Humans COPD 030212 general & internal medicine Poisson regression older adults acute exacerbation Aged Original Research Aged 80 and over business.industry Proportional hazards model Incidence (epidemiology) General Medicine medicine.disease Prognosis mortality Clinical Interventions in Aging symbols Disease Progression Female Geriatrics and Gerontology medicine.symptom business 030217 neurology & neurosurgery |
Zdroj: | Clinical Interventions in Aging |
ISSN: | 1178-1998 |
Popis: | Jia Luo, Dai Zhang, Wen Tang, Li-Yang Dou, Ying Sun Department of Geriatrics, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, People’s Republic of ChinaCorrespondence: Ying SunDepartment of Geriatrics, Beijing Friendship Hospital, Capital Medical University, No. 95, Yong’an Road, Xicheng District, Beijing, 100050, People’s Republic of ChinaTel + 86 10 63137737Fax + 86 10 63138795Email ysun15@163.comDai ZhangDepartment of Geriatrics, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, People’s Republic of ChinaEmail zhangdai0806@126.comRationale: For the high prevalence of frail in patients with chronic obstructive pulmonary disease (COPD), further study should explore an in-depth understanding of the relationship between frailty and prognosis of COPD.Objective: To determine the correlation between frailty and risk of acute exacerbation, hospitalizations, and mortality in older patients with stable COPD.Participants and Methods: Consecutive older adults (≥ 65) diagnosed with stable COPD from January 2018 to July 2019, with an average follow-up of 546 days (N = 309). Frailty was defined by the Fried frailty phenotype. Poisson regression was performed to assess the influence of frailty on the incidence of acute exacerbations of COPD (AECOPD) and all-cause hospitalizations in a year. Cox regression was performed to evaluate the effect of frailty on all-cause mortality in patients with stable COPD.Results: The prevalence of frailty was 49.8%. The most common phenotypic characteristics were weakness (99.4%) followed by slowness (92.9%). After adjustment, frailty increased the incidence of AECOPD (IRR = 1.75, 95% CI: 1.09– 2.82) and all-cause hospitalizations (IRR = 1.39, 95% CI 1.04– 1.87) within a year. Slowness was associated with AECOPD (IRR = 1.77, 95% CI: 1.03– 3.03), and weakness was associated with increased all-cause hospitalizations (IRR = 1.53, 95% CI: 1.04– 2.25). The all-cause mortality risk was more than twofold higher in frail patients (HR = 2.54, 95% CI: 1.01– 6.36) than non-frail patients. Low physical activity (HR = 2.66, 95% CI: 1.17– 6.05) and weight loss (HR = 2.15, 95% CI: 1.02– 4.51) were significantly associated with increased all-cause mortality in patients with COPD.Conclusion: Frailty increased the incidence of acute exacerbation and hospitalization, as well as increased mortality in older patients with stable COPD. This knowledge will help physicians identify high-risk groups with COPD and frailty who may benefit from targeted interventions to prevent disease progression.Keywords: COPD, frailty, older adults, acute exacerbation, mortality |
Databáze: | OpenAIRE |
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