Background Although frailty is associated with a range of adverse health outcomes, its association with the risk of hospital-treated infections is uncertain. Methods A total of 416 220 participants from the UK Biobank were included in this prospective cohort study. Fried phenotype was adopted to evaluate frailty, which included 5 aspects (gait speed, physical activity, grip strength, exhaustion, and weight). More than 800 infectious diseases were identified based on electronic health records. Cox proportional models were used to estimate the associations. Results During a median 12.3 years (interquartile range 11.4–13.2) of follow-up (4 747 345 person-years), there occurred 77 988 (18.7%) hospital-treated infections cases. In the fully adjusted model, compared with participants with nonfrail, the hazard ratios (HRs) (95% confidence intervals [CIs]) of those with prefrail and frail for overall hospital-treated infections were 1.22 (1.20, 1.24) and 1.78 (1.72–1.84), respectively. The attributable risk proportion of prefrail and frail were 18.03% and 43.82%. Similarly, compared to those without frailty, the HRs (95% CIs) of those with frailty for bacterial infections were 1.76 (1.70–1.83), for viral infections were 1.62 (1.44–1.82), and for fungal infections were 1.75 (1.47–2.08). No association was found between frailty and parasitic infections (HR: 1.17; 95% CI: 0.62–2.20). Conclusions Frailty was significantly associated with a higher risk of hospital-treated infections, except for parasitic infections. Studies evaluating the effectiveness of implementing frailty assessments are needed to confirm our results.

中文翻译：

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中老年人虚弱与医院治疗感染风险的相关性：一项大规模前瞻性队列研究


背景 尽管虚弱与一系列不良健康结局有关，但其与医院治疗感染风险的相关性尚不确定。方法 本前瞻性队列研究共纳入来自英国生物样本库的 416 220 名参与者。采用 Fried 表型评价虚弱，包括 5 个方面 （步态速度、体力活动、握力、疲惫和体重）。根据电子健康记录确定了 800 多种传染病。使用 Cox 比例模型估计相关性。结果 在中位 12.3 年 （四分位距 11.4-13.2） 的随访 （4 747 345 人年） 期间，发生了 77 988 例 （18.7%） 医院治疗的感染病例。在完全调整的模型中，与非虚弱参与者相比，早期虚弱和虚弱患者在医院治疗的整体感染中的风险比 （HR） （95% 置信区间 [CI]）分别为 1.22 （1.20， 1.24） 和 1.78 （1.72-1.84）。前衰和虚弱的归因风险比例分别为 18.03% 和 43.82%。同样，与没有虚弱的人相比，虚弱的人的细菌感染 HRs （95% CIs） 为 1.76 （1.70-1.83），病毒感染为 1.62 （1.44-1.82），真菌感染为 1.75 （1.47-2.08）。未发现虚弱与寄生虫感染之间存在关联 （HR： 1.17;95% CI： 0.62-2.20）。结论 除寄生虫感染外，虚弱与医院治疗感染风险较高显著相关。需要研究评估实施衰弱评估的有效性，以确认我们的结果。