当前位置: X-MOL 学术J. Acquir. Immune Defic. Syndr. › 论文详情
Our official English website, www.x-mol.net, welcomes your feedback! (Note: you will need to create a separate account there.)
Physical Function and Frailty Tools in Mortality Prediction of Middle-Aged Adults With HIV
JAIDS: Journal of Acquired Immune Deficiency Syndromes ( IF 3.6 ) Pub Date : 2020-11-01 , DOI: 10.1097/qai.0000000000002455
Regan Pelloquin , Mona Abdo , Samantha MaWhinney , Catherine M. Jankowski , Kristine M. Erlandson

Background: 

Frailty and physical function impairments occur at an earlier than expected age in people with HIV (PWH). The goal of this study was to determine which tools or combination of tools assessing frailty/physical function were most predictive of mortality in a middle-aged population of PWH.

Methods: 

Using electronic health records, we determined survival, death, or loss to follow-up for 359 PWH, aged 45–65 years originally enrolled in a 2009–2010 cross-sectional cohort study. The predictive accuracy of various physical function measures [frailty score, Veterans Aging Cohort Study (VACS) index, 400-m walk, Short Physical Performance Battery (SPPB), grip strength, and falls] were compared using integrated time-dependent receiver operating characteristic area under the curve (AUC) in single variable models. Two-variable models were compared with the best single-variable model to determine if AUC improved with additional physical function variables.

Results: 

At 8-year follow-up, frailty, 400-m walk pace, SPPB, chair rise pace, VACS score, and falls were associated with increased hazard of mortality; grip strength was only predictive in sex-adjusted models. The VACS index and 400-m walk pace were the best individual predictors of mortality with time-dependent receiver operating characteristic AUC scores of 0.82, followed by SPPB (0.73), chair-rise pace (0.68), falls (0.65), frailty (0.63), and grip strength (0.55). Addition of the 400-m walk to VACS index yielded the only significant improvement in the prediction of survival compared with the VACS index alone (P = 0.04).

Conclusion: 

Our study highlights several clinically applicable physical function measures predictive of mortality in middle-aged PWH that can be tailored to specific patient subpopulations and clinical or research encounters.



中文翻译:

身体功能和脆弱性工具在中年艾滋病毒成年人死亡率预测中的作用

背景: 

艾滋病毒感染者(PWH)的衰弱身体机能障碍发生的时间早于预期年龄。这项研究的目的是确定评估脆弱/身体机能的哪些工具或工具组合最能预测中年PWH人群的死亡率

方法: 

利用电子健康记录,我们确定了最初参加2009-2010年横断队列研究的359名PWH的生存,死亡或损失,年龄45-65岁。使用综合的随时间变化的接收器工作特性,比较了各种身体机能指标的预测准确性[脆弱性评分,退伍军人老化队列研究(VACS)指数,400米步行,短物理性能电池(SPPB),抓地力和跌倒]单变量模型中曲线下的面积(AUC)。将两变量模型与最佳单变量模型进行比较,以确定是否可以通过使用其他物理功能变量来改善AUC 。

结果: 

在8年的随访中,虚弱,步行400米的步伐,SPPB,椅子上升的步伐,VACS评分和跌倒与死亡风险增加相关;握力仅在性别调整模型中具有预测性。VACS指数和400-m步行速度是死亡率的最佳个体预测指标,其随时间变化的接收器操作特征AUC得分为0.82,其次是SPPB(0.73),椅子上升速度(0.68),跌倒(0.65),虚弱( 0.63)和握力(0.55)。与单独的VACS指数相比,VACS指数增加了400米步行路程在生存预测方面产生了唯一的显着改善(P = 0.04)。

结论: 

我们的研究重点介绍了可预测中年PWH死亡率的几种临床适用的身体机能指标,这些指标可以针对特定的患者亚群以及临床或研究遇到的情况进行定制。

更新日期:2020-10-20
down
wechat
bug