3种衰弱评估工具对急诊老年创伤患者不良结局的预测价值

doi:10.3761/j.issn.0254-1769.2026.09.007

中华护理杂志 ›› 2026, Vol. 61 ›› Issue (9): 1200-1207.DOI: 10.3761/j.issn.0254-1769.2026.09.007

3种衰弱评估工具对急诊老年创伤患者不良结局的预测价值

陈晨¹(), 顾肖¹^,^*(), 郭凡¹, 王敏¹, 倪兴梅¹, 黄琴², 程念开²

¹ 南京医科大学附属苏州医院/苏州市立医院急危重症医学部苏州市 215000
² 南京医科大学附属苏州医院/苏州市立医院护理部苏州市 215000

收稿日期:2025-12-04 出版日期:2026-05-10 发布日期:2026-04-30
*通讯作者: 顾肖，E⁃mail：1021420954@qq.com
作者简介:陈晨：女，硕士，主管护师，E⁃mail：13771836249@163.com
第一联系人：作者贡献声明
陈晨：研究设计、数据收集、数据整理、统计学分析、论文撰写；顾肖：研究设计、数据收集、数据整理、统计学分析、论文撰写；郭凡、王敏：数据收集、研究指导、论文审阅与修改；倪兴梅：数据收集；黄琴、程念开：研究指导、论文审阅与修改
基金资助:
苏州市护理学会姑苏护理人才“青苗”计划(SHQM202501)

Predictive value of 3 frailty assessment tools for adverse outcomes in elderly trauma patients in an emergency department

CHEN Chen¹(), GU Xiao¹^,^*(), GUO Fan¹, WANG Min¹, NI Xingmei¹, HUANG Qin², CHENG Niankai²

¹ Department of Critical Care Medicine and Emergency， Suzhou Municipal Hospital， Suzhou 215000， China
² Nursing Department， Suzhou Municipal Hospital， Suzhou 215000， China

Received:2025-12-04 Online:2026-05-10 Published:2026-04-30
* Corresponding author: GU Xiao，E⁃mail：1021420954@qq.com
Funding program:
Suzhou Nursing Association Gusu Nursing Talent “Qing Miao” Program(SHQM202501)

摘要/Abstract

摘要：

目的比较衰弱筛查量表（Fatigue，Resistance，Ambulation，Illness，Loss of weight，FRAIL）、临床衰弱量表（Clinical Frailty Scale，CFS）、创伤特异性衰弱指数（Trauma-Specific Frailty Index，TSFI）对急诊老年创伤患者发生不良结局的预测能力。方法采用前瞻性队列研究设计，选取2025年1—6月在苏州市某三级甲等医院259例急诊老年创伤患者为调查对象，分别使用FRAIL、CFS、TSFI评估衰弱程度，通过计算受试者操作特征曲线下面积（area under the curve，AUC），比较3种评估工具对急诊老年创伤患者发生不良结局的预测价值。结果共纳入248例，75例（30.2%）发生不良结局纳入事件组，173例（69.8%）未发生不良结局纳入非事件组，两组间衰弱评分差异具有统计学意义（P<0.001）。FRAIL的AUC为0.74，敏感度和特异度分别为0.64、0.78；CFS的AUC为0.70，敏感度和特异度分别为0.59、0.75；TSFI的AUC为0.83，敏感度和特异度分别为0.83、0.80。结论 TSFI相较FRAIL和CFS在预测急诊老年创伤患者不良结局方面效能较好，更适合国内急诊入院老年创伤患者的早期衰弱评估。

关键词: 创伤, 老年人, 衰弱, 量表, 预测, 急救护理

Abstract:

Objective To compare the predictive value of the Fatigue，Resistance，Ambulation，Illness and Loss of weight（FRAIL），Clinical Frailty Scale（CFS），and Trauma-Specific Frailty Index（TSFI） for adverse outcomes in elderly trauma patients in an emergency department. Methods This prospective cohort study enrolled 259 elderly trauma patients admitted to a tertiary hospital in Suzhou，China（January to June 2025）. Frailty was assessed using FRAIL，CFS，and TSFI. The predictive value of these tools for adverse outcomes in elderly emergency trauma patients was compared using the area under the receiver operating characteristic curve（AUC）. Results Among 248 included patients，75 patients（30.2%） who experienced adverse outcomes were included in an event group，and 173 patients（69.8%） who did not experience adverse outcomes were in a non-event group. Frailty scores differed significantly between groups（P<0.001）. ROC analysis revealed that TSFI（AUC=0.83，sensitivity=0.83，specificity=0.80） showed higher predictive accuracy than FRAIL（AUC=0.74，sensitivity=0.64，specificity=0.78） and CFS（AUC=0.70，sensitivity=0.59，specificity=0.75）. Conclusion TSFI demonstrated superior predictive efficacy for adverse outcomes in elderly trauma patients，making it more suitable for early frailty assessment in Chinese emergency departments.

Key words: Trauma, Aged, Frailty, Scale, Prediction, Emergency Nursing

陈晨, 顾肖, 郭凡, 王敏, 倪兴梅, 黄琴, 程念开. 3种衰弱评估工具对急诊老年创伤患者不良结局的预测价值[J]. 中华护理杂志, 2026, 61(9): 1200-1207.

CHEN Chen, GU Xiao, GUO Fan, WANG Min, NI Xingmei, HUANG Qin, CHENG Niankai. Predictive value of 3 frailty assessment tools for adverse outcomes in elderly trauma patients in an emergency department[J]. Chinese Journal of Nursing, 2026, 61(9): 1200-1207.

图/表 5

表1 调查对象的基本信息及不良结局的单因素分析

Table 1 Basic information of the study subjects and single-factor analysis of adverse outcomes

表2 事件组和非事件组创伤、风险评估及血液指标的比较

Table 2 Comparison of trauma，risk assessment，and blood parameters between the event group and the non-event group

表3 随访3个月内急诊老年创伤患者再入院、再跌倒、死亡与FRAIL、CFS、TSFI评分的关系[例（百分比，%）]

Table 3 Comparison of FRAIL，CFS，TSFI scores and adverse outcomes within 3 months of follow-up[cases（percentages，%）]

表4 FRAIL、CFS、TSFI评分与急诊老年创伤患者不良结局的关系[例（百分比，%）]

Table 4 Relationship between patients’ FRAIL，CFS，and TSFI scores and adverse events[cases（percentages，%）]

图1 3种衰弱评分工具的受试者操作特征曲线注：TSFI为创伤特异性衰弱指数，FRAIL为衰弱筛查量表，CFS为临床衰弱量表。

Figure 1 ROC curves for 3 frailty scoring tools

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3种衰弱评估工具对急诊老年创伤患者不良结局的预测价值

Predictive value of 3 frailty assessment tools for adverse outcomes in elderly trauma patients in an emergency department

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