Background Frailty is a widely used measure in older patients as a predictor of poor outcomes after hospitalization and surgery. There is a growing body of data in kidney transplantation suggesting frailty can predict adverse outcomes. There is interest in using chart review measures of frailty and multimorbidity, as they may be equally predictive as physical measurement. This approach holds promise for patient evaluation, identifying candidates for prehabilitation, and targeting resources towards those anticipated to have an increased rate of clinical challenges after kidney transplantation. Frail patients who are often older may place a large resource and economic burden on transplant programs. Methods We applied a previously published chart review-based approach in a retrospective, pilot study to calculate the Frailty Risk Score (FRS) utilizing a cohort of kidney transplant patients. We reviewed concurrent comorbidities using the Charlson comorbidity (CM) score to determine the feasibility and utility of applying this approach in transplant patients to predict post-transplant outcomes such as length of hospitalization and the need for rehospitalization. Results Sixty kidney transplant recipients were evaluated by chart review, 23 characterized as older (> = 60) and 37 younger (ages 30-59). Median FRS score was 3 (range 1-7). Higher FRS was significantly associated with increased patient age (high FRS 19% in younger patients, 43% in older patients). Increased CM score was also associated with increased patient age. Patients with a high FRS stayed in the hospital for an average of 8 days, compared with 5.7 days for a low FRS. Patients with high FRS were readmitted an average of 2.9 times compared with an average of 1.1 for those with a low FRS. FRS score remained significant for predicting outcomes after adjustment for patient age. Conclusion Elevated FRS prior to transplantation was associated with increased hospital stay and the need for readmission in kidney transplant recipients. This analysis demonstrates the potential strength of chart review in evaluating frailty prior to transplantation, permitting risk stratification and targeting of resources for rehabilitation and close post-transplant monitoring. Frail patients may benefit from targeted "prehabilitation" to attenuate the associated adverse clinical outcomes.

中文翻译：

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在一项回顾性队列中，衰弱风险评分预测肾移植后的住院时间和再住院需要：一项初步研究。

背景虚弱是一种在老年患者中广泛使用的指标，可作为住院和手术后不良结果的预测指标。越来越多的肾移植数据表明，虚弱可以预测不良后果。人们有兴趣使用虚弱和多病的图表审查措施，因为它们可能与物理测量一样具有预测性。这种方法有望用于患者评估，确定预康复的候选者，并将资源用于那些预计在肾移植后临床挑战率增加的人。通常年龄较大的虚弱患者可能会给移植计划带来巨大的资源和经济负担。方法 我们在回顾中应用了以前发表的基于图表审查的方法，利用一组肾移植患者计算虚弱风险评分 (FRS) 的试点研究。我们使用 Charlson 合并症 (CM) 评分审查了并发合并症，以确定在移植患者中应用这种方法来预测移植后结果（例如住院时间和再次住院的需要）的可行性和实用性。结果 通过图表审查评估了 60 名肾移植受者，其中 23 名年龄较大（> = 60），37 名年龄较小（30-59 岁）。FRS 评分中位数为 3（范围 1-7）。较高的 FRS 与患者年龄增加显着相关（年轻患者 FRS 高 19%，老年患者 43%）。CM评分增加也与患者年龄增加有关。FRS 高的患者平均住院 8 天，而 5 天。低 FRS 为 7 天。高 FRS 患者平均再入院 2.9 次，而低 FRS 患者平均为 1.1 次。在调整患者年龄后，FRS 评分对于预测结果仍然具有显着性。结论 移植前 FRS 升高与肾移植受者住院时间延长和再入院需求相关。该分析表明图表审查在评估移植前的虚弱、允许风险分层和定位资源用于康复和移植后密切监测方面的潜在优势。体弱的患者可能会受益于有针对性的“预康复”，以减轻相关的不良临床结果。1适用于FRS低的人。在调整患者年龄后，FRS 评分对于预测结果仍然具有显着性。结论 移植前 FRS 升高与肾移植受者住院时间延长和再入院需求相关。该分析表明图表审查在评估移植前的虚弱、允许风险分层和定位资源用于康复和移植后密切监测方面的潜在优势。体弱的患者可能会受益于有针对性的“预康复”，以减轻相关的不良临床结果。1适用于FRS低的人。在调整患者年龄后，FRS 评分对于预测结果仍然具有显着性。结论 移植前 FRS 升高与肾移植受者住院时间延长和再入院需求相关。该分析表明图表审查在评估移植前的虚弱、允许风险分层和定位资源用于康复和移植后密切监测方面的潜在优势。体弱的患者可能会受益于有针对性的“预康复”，以减轻相关的不良临床结果。结论 移植前 FRS 升高与肾移植受者住院时间延长和再入院需求相关。该分析表明图表审查在评估移植前的虚弱、允许风险分层和定位资源用于康复和移植后密切监测方面的潜在优势。体弱的患者可能会受益于有针对性的“预康复”，以减轻相关的不良临床结果。结论 移植前 FRS 升高与肾移植受者住院时间延长和再入院需求相关。该分析表明图表审查在评估移植前的虚弱、允许风险分层和定位资源用于康复和移植后密切监测方面的潜在优势。体弱的患者可能会受益于有针对性的“预康复”，以减轻相关的不良临床结果。