老年急性心肌梗死患者衰弱评价及危险因素分析

Frailty and risk factors in elderly patients with acute myocardial infarction

目的探讨老年急性心肌梗死行择期冠状动脉介入术(PCI)患者的衰弱现状及危险因素,为早期筛检和预防急性心肌梗死老年患者预防衰弱提供参考。方法选取心血管内科行择期PCI的老年急性心肌梗死患者158例,采用Fried表型衰弱量表于术前评估其衰弱状况,采用单因素及Logistic多因素分析老年急性心肌梗死患者合并衰弱的危险因素。结果急性心肌梗死合并衰弱患者44例(27.85%);衰弱较非衰弱者在机体的生理、心理及心脏功能方面差异显著,且增龄、长期服用多种药物、查尔森共病指数(CCI)评分、日常生活能力障碍、肌钙蛋白I为老年急性心肌梗死患者发生衰弱的危险因素(P<0.05)。结论老年急性心肌梗死患者衰弱发生率较高,影响衰弱的危险因素较多,衰弱的预防及改善需结合老年人生理、心理及客观实验室指标等多领域的综合干预。

Objective To explore the status of and risk factors for frailty in elderly patients with acute myocardial infarction(AMI)receiving percutaneous coronary intervention(PCI),and to provide reference for early screening and prevention of frailty.Methods A total of 158 elderly AMI patients receiving elective PCI in the department of cardiology were assessed using the Fried Frailty Phenotype Scale before the surgery,then risk factors were identified through univariate analysis and Logistic regression analysis.Results Forty-four patients(27.85%)developed frailty.There were significant differences in physical,psychological and cardiac function between frailty and non-frailty patients,and advanced age,long-term use of multiple medications,Charlson Comorbidity Index score,impairment of activities of daily living,IcTnI were risk factors for frailty in elderly AMI patients(P<0.05).Conclusion The prevalence of frailty in elderly AMI patients was high and affected by multiple factors.Preventive measures should be developed by considering physical,psychological and laboratory indexes of the patients.