| Project/Area Number |
18K08887
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Multi-year Fund |
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| Section | 一般 |
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| Review Section |
Basic Section 55060:Emergency medicine-related
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| Research Institution | Okayama University |
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Principal Investigator |
Naito Hiromichi 岡山大学, 医歯薬学総合研究科, 准教授 (00536774)
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| Co-Investigator(Kenkyū-buntansha) |
頼藤 貴志 岡山大学, 医歯薬学総合研究科, 教授 (00452566)
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| Project Period (FY) |
2018-04-01 – 2021-03-31
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| Project Status |
Completed (Fiscal Year 2020)
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| Budget Amount *help |
¥4,420,000 (Direct Cost: ¥3,400,000、Indirect Cost: ¥1,020,000)
Fiscal Year 2020: ¥1,690,000 (Direct Cost: ¥1,300,000、Indirect Cost: ¥390,000)
Fiscal Year 2019: ¥1,170,000 (Direct Cost: ¥900,000、Indirect Cost: ¥270,000)
Fiscal Year 2018: ¥1,560,000 (Direct Cost: ¥1,200,000、Indirect Cost: ¥360,000)
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| Keywords | フレイル / 高齢者 / 救急医療 / 集中治療 / 予後 / 予後予測 / QOL / 救急 / フレイル・スケール |
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| Outline of Final Research Achievements |
We tested whether the Clinical Frailty Scale: CFS would impact the 6-month mortality and quality of life (QOL) after receiving intensive care in elderly patients. A prospective multi-center observational study was conducted in patients 65 years or older who visited the emergency department of participating facilities and admitted to the intensive care unit.
Six-month mortality was observed in 653 patients from 17 participating facilities across Japan; 6-month mortality was worse in the frailty patients showing higher CFS. After adjusting for age and severity of illness, CFS remained as an independent prognostic factor for mortality (adjusted odds ratio: 1.28 for higher CFS). Similarly, higher CFS was associated with poorer QOL.
CFS measured at the time of emergent intensive care admission for the elderly was a reliable prognostic factor for 6-month mortality.
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| Academic Significance and Societal Importance of the Research Achievements |
本研究によって本邦の救急・集中治療を受ける高齢者の臨床フレイル・スケール（CFS）ごとの6か月後死亡率や生活の質（QOL）が明らかとなった。また、CFSが救急集中治療の予後やQOLを予測する有用な指標であることが示された。海外ではすでに行われているように、今後、本邦でも高齢者の治療・療養について患者・家族と医療従事者があらかじめ話し合う自発的なプロセスが重要視されると考えられる。高齢者に対する救急集中治療導入時にCFSを用いた予後予測を行い、本人の意思や家族の希望と併せてより効果的な治療導入のための方針決定に役立てられることを期待する。
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