Tilburg衰弱量表和衰弱表型对住院老年患者衰弱评估效果初步研究

A preliminary study of the effect of Tilburg debilitation scale and debilitation phenotype on the evaluation of debilitation in elderly inpatients

目的探讨Tilburg衰弱量表(TFI)和衰弱表型(PF)对住院老年患者衰弱的评估效果。方法选取2018年1月~2019年12月在安徽医科大学附属合肥医院全科医学科住院的老年患者114例,患者在完成常规体检后分别应用Tilburg衰弱量表和衰弱表型定义完成衰弱评估,并对评估结果进行比较分析。结果60~69岁患者的TFI、PF评分均低于70~79岁的患者,两者比较差异具有统计学意义(P<0.05)。TFI、PF分值与患者年龄呈正相关(r=0.923、0.871,P<0.001)。TFI与PF的一致性Kappa值为0.744(P<0.001)。多因素回归分析结果显示,70~79岁者、女性、超重或肥胖、基础疾病>2种、服药种类>3种、从不或偶尔运动、抑郁均为衰弱的危险因素。结论衰弱程度与年龄呈正相关,年龄、性别、体质量指数(BMI)、基础疾病、用药情况、运动及抑郁均对衰弱病情有影响,TFI衰弱评估敏感性较高,更能有效筛选临床衰弱前期患者,从而达到早期干预及治疗的目的。

Objective To explore the evaluation effect of Tilburg debilitation scale and debilitation phenotype on the debilitation of elderly inpatients,and to provide reference for the evaluation of debilitation of elderly inpatients.Methods From January 2018 to December 2019,114 elderly patients in the general practice department of our hospital were selected as the research objects.After completing the routine physical examination,the patients were assessed with the Tilburg debilitation scale and the definition of debilitation phenotype respectively,and the assessment results were analyzed.Results The TFI and PF scores of 60~69 years old patients were lower than those of 70~79 years old patients,the difference was statistically significant(P<0.05).TFI and PF scores were positively correlated with age(r=0.923,0.871,P<0.001).The kappa value of TFI and PF was 0.744(P<0.001).Multifactorial regression analysis showed that 70~79 year olds,women,overweight or obese,>2 underlying diseases,>3 medications,never or occasional exercise,and depression were all risk factors for debilitation.Conclusion There is a positive correlation between the degree of debilitation and age.Age,sex,Body Mass Index(BMI),underlying illness,medication,exercise and depression all have an impact on debilitating conditions.TFI is more sensitive to evaluate debilitation.It is more effective to screen patients in the early stage of clinical debilitation,and to achieve the purpose of early intervention and treatment.