"起立-行走"计时测试对老年心血管疾病住院患者衰弱状态的预测价值

Predictive value of the timed "up and go" test on frailty of elderly inpatients with cardiovascular disease

目的探寻"起立-行走"计时测试(TUGT)对老年心血管疾病住院患者衰弱状态的预测效能,为临床衰弱状态评估提供客观的参考依据。方法采用便利抽样法,选取2019年5-7月在汕头大学医学院第二附属医院心血管内科住院的156例老年患者为研究对象,采用衰弱表型量表评估其衰弱情况、应用TUGT对其进行步行功能记录,采用ROC分析TUGT对老年心血管疾病住院患者衰弱状态的预测效能。结果ROC曲线分析显示,预测60~69岁患者衰弱状态的TUGT最佳临界值为15.17 s,其曲线下面积(AUC)为0.827,95%CI为0.727~0.902,敏感度为66.67%,特异度为98.04%;预测≥70岁患者衰弱状态的TUGT最佳临界值为15.26 s,其AUC为0.829,95%CI为0.724~0.906,敏感度为77.50%,特异度为82.86%。结论TUGT在老年住院患者衰弱评估中具有中等的预测效能,但其可提供客观而有效的临床数据参考,而且该测试快速、简便、临床易操作,可作为心血管疾病老年住院患者衰弱的初步筛查。

Objective To explore the predictive efficiency of the timed"up and go"test(TUGT)on the frailty of elderly inpatients with cardiovascular disease and to provide an objective reference for clinical assessment of frailty.Methods According to the convenience sampling method,a total of 156 elderly patients who were hospitalized in Cardiovascular Department in the Second Affiliated Hospital of Shantou University Medical College from May to July 2019 were selected as research objects.Frailty Phenotype Scale was used to evaluate their frailty,TUGT was used to record their walking function and ROC was used to analyze the predictive efficiency of TUGT on the frailty of elderly inpatients with cardiovascular disease.Results ROC curve analysis showed that the optimal critical value of TUGT for predicting frailty of patients aged 60 to 69 years was 15.17 s,area under curve(AUC)was 0.827,95%CI was 0.727 to 0.902,the sensitivity was 66.67%and the specificity was 98.04%.The optimal critical value of TUGT for predicting frailty of patients aged equal or over to 70 years was 15.26 s,AUC was 0.829,95%CI was 0.724 to 0.906,the sensitivity was 77.50%and the specificity was 82.86%.Conclusions TUGT has moderate predictive efficacy in assessment of frailty in elderly inpatients,but it can provide an objective and effective reference for clinical data.Moreover,the test is fast,simple and clinically easy to operate,which can be used as a preliminary screening for frailty in elderly inpatients with cardiovascular diseases.