PDF(Pubmed)
Abstract：
OBJECTIVE: Frailty is a vulnerable state to stressors due to the loss of physiological reserve as a result of multisystem dysfunction. The physiological and laboratory-based frailty index (FI-Lab), depending on laboratory values and vital signs, is a powerful tool to capture frailty status. The aim of this study was to assess the relationship between FI-Lab and in-hospital mortality in patients with septic shock.
METHODS: Baseline data for patients with sepsis in the intensive care unit were retrieved from the Critical Care Medicine Database (MIMIC-IV, v2.2). The primary outcome was mortality during hospitalization. The propensity score matching (PSM) method was used to analyze the basic conditions during hospitalization between groups.The FI-Lab was analysed for its relationship with in-hospital mortality using logistic regression according to continuous and categorical variables, respectively, and described using the restricted cubic spline (RCS). Survival was compared between groups using Kaplan-Meier (KM) curves. Subgroup analyses were used to improve the stability of the results.
RESULTS: A total of 9219 patients were included. A cohort score of 1803 matched patients was generated after PSM. The analyses showed that non-surviving patients with septic shock in the ICU had a high FI-Lab index (P<0.001). FI-Lab, whether used as a continuous or categorical variable, increased with increasing FI-Lab and increased in-hospital mortality (P<0.001).Subgroup analyses showed similar results. RCS depicts this non-linear relationship. KM analysis shows the cumulative survival time during hospitalisation was significantly lower as FI-Lab increased (log-rank test, P<0.001).
CONCLUSIONS: Elevated FI-Lab is associated with increased in-hospital mortality in patients with septic shock.
METHODS: Baseline data for patients with sepsis in the intensive care unit were retrieved from the Critical Care Medicine Database (MIMIC-IV, v2.2). The primary outcome was mortality during hospitalization. The propensity score matching (PSM) method was used to analyze the basic conditions during hospitalization between groups.The FI-Lab was analysed for its relationship with in-hospital mortality using logistic regression according to continuous and categorical variables, respectively, and described using the restricted cubic spline (RCS). Survival was compared between groups using Kaplan-Meier (KM) curves. Subgroup analyses were used to improve the stability of the results.
RESULTS: A total of 9219 patients were included. A cohort score of 1803 matched patients was generated after PSM. The analyses showed that non-surviving patients with septic shock in the ICU had a high FI-Lab index (P<0.001). FI-Lab, whether used as a continuous or categorical variable, increased with increasing FI-Lab and increased in-hospital mortality (P<0.001).Subgroup analyses showed similar results. RCS depicts this non-linear relationship. KM analysis shows the cumulative survival time during hospitalisation was significantly lower as FI-Lab increased (log-rank test, P<0.001).
CONCLUSIONS: Elevated FI-Lab is associated with increased in-hospital mortality in patients with septic shock.
摘要：
目的：脆弱是由于多系统功能障碍导致的生理储备丧失而对应激源的脆弱状态。基于生理和实验室的虚弱指数(FI-Lab)，根据实验室值和生命体征，是捕获脆弱状态的强大工具。这项研究的目的是评估FI-Lab与感染性休克患者住院死亡率之间的关系。
方法：从重症监护医学数据库中检索重症监护病房脓毒症患者的基线数据（MIMIC-IV，V2.2).主要结果是住院期间的死亡率。采用倾向评分匹配(PSM)法对组间住院期间的基本情况进行分析。根据连续变量和分类变量，使用逻辑回归分析FI-Lab与住院死亡率的关系，分别,并使用受限三次样条(RCS)进行描述。使用Kaplan-Meier(KM)曲线比较各组之间的生存率。亚组分析用于提高结果的稳定性。
结果：共纳入9219例患者。PSM后产生1803名匹配患者的队列评分。分析结果显示，ICU中败血症性休克患者的FI-Lab指数较高（P<0.001）。FI-Lab,无论是用作连续变量还是分类变量，随着FI-Lab的增加和院内死亡率的增加(P<0.001)。亚组分析显示相似的结果。RCS描述了这种非线性关系。KM分析显示，随着FI-Lab增加，住院期间的累积生存时间显着降低（对数秩检验，P<0.001)。
结论：FI-Lab升高与脓毒性休克患者住院死亡率增加相关。
方法：从重症监护医学数据库中检索重症监护病房脓毒症患者的基线数据（MIMIC-IV，V2.2).主要结果是住院期间的死亡率。采用倾向评分匹配(PSM)法对组间住院期间的基本情况进行分析。根据连续变量和分类变量，使用逻辑回归分析FI-Lab与住院死亡率的关系，分别,并使用受限三次样条(RCS)进行描述。使用Kaplan-Meier(KM)曲线比较各组之间的生存率。亚组分析用于提高结果的稳定性。
结果：共纳入9219例患者。PSM后产生1803名匹配患者的队列评分。分析结果显示，ICU中败血症性休克患者的FI-Lab指数较高（P<0.001）。FI-Lab,无论是用作连续变量还是分类变量，随着FI-Lab的增加和院内死亡率的增加(P<0.001)。亚组分析显示相似的结果。RCS描述了这种非线性关系。KM分析显示，随着FI-Lab增加，住院期间的累积生存时间显着降低（对数秩检验，P<0.001)。
结论：FI-Lab升高与脓毒性休克患者住院死亡率增加相关。
