International Journal of COPD (Apr 2021)
A Frailty Assessment Tool to Predict In-Hospital Mortality in Patients with Acute Exacerbations of Chronic Obstructive Pulmonary Disease
Abstract
Jin-Jin Gu,1 Qiang Liu,2 Li-Jie Zheng3 1Department of Geriatrics, The Affiliated People’s Hospital of Jiangsu University, Zhenjiang, 212002, People’s Republic of China; 2Department of Laboratory Medicine, The Affiliated Hospital of Jiangsu University, Zhenjiang, 212001, People’s Republic of China; 3Department of Laboratory Medicine,The Affiliated People’s Hospital of Jiangsu University, Zhejiang, 212002, People’s Republic of ChinaCorrespondence: Jin-Jin GuDepartment of Geriatrics, The Affiliated People’s Hospital of Jiangsu University, No. 8 Dianli Road, Zhenjiang, 212002, People’s Republic of ChinaTel +86 511 88915421Email [email protected]: The exacerbation of chronic obstructive pulmonary disease (AECOPD) is a chronic, frequent, and life-threatening lung disease. In 2014, a frailty index (FI) based on deficits in commonly used laboratory tests (FI-Lab) was suggested to identify older adults at increased risk of death.Objective: We aim to study the prognostic value of the FI-Lab in older Chinese patients who were admitted because of AECOPD.Methods: We screened 1932 older patients hospitalized with AECOPD from September 2016 to June 2019 at Zhenjiang First People’s Hospital, China. A multivariate logistic regression analysis was used to identify prognostic factors for in-hospital mortality.Results: A total of 77 survivors and 77 non-survivors were finally included in the study. Both the mean DECAF (including dyspnea, eosinopenia, consolidation, acidemia, and atrial fibrillation) score and the mean FI-Lab value of non-survivors were statistically higher than those of survivors (4.45 ± 0.80 versus 3.03 ± 0.90, P=0.000; 0.51 ± 0.13 versus 0.29 ± 0.10, P=0.000, respectively). Logistic regression analysis suggested that DECAF Rank and FI-Lab Rank were strongly related factors of death in AECOPD patients. The areas under the receiver-operating characteristic (ROC) curves were 0.906 for FI-Lab and 0.870 for DECAF (P=0.2991).Conclusion: FI-Lab is a simple, efficient, and objective tool to stratify the risk of in-hospital mortality of AECOPD.Keywords: frailty index, FI-Lab, DECAF, AECOPD, prognosis
