住院老年人慢性病状况及合并衰弱相关因素研究

Study on Prevalence of Chronic Disease-related Frailty in Hospitalized Older Patients

目的调查住院老年人慢性病状况及合并衰弱相关因素,为住院老年人衰弱的防控提供科学依据。方法选择亳州市人民医院住院老年患者1179例,以现场问卷调查并结合体格检查、FRAIL量表进行衰弱状态评估,统计学方法分析衰弱的影响因素。结果住院老年患者慢性病发生情况:冠心病(68.1%)、高血压(67.7%)、脑卒中(54.4%)、营养不良(42.3%)、慢性阻塞性肺疾病(34.7%)、糖尿病(24.2%);在不同年龄组冠心病、房颤、慢性阻塞性肺疾病、营养不良、前列腺增生、白内障及骨折患病率比较差异均有统计学意义(P<0.05)。不同年龄组患病种数及服药种数差异有统计学意义(P<0.05)。衰弱发生情况:无衰弱291例(24.7%)、衰弱前期319例(27.1%)、衰弱期569例(48.3%)。在不同衰弱等级的单因素分析中,是否合并冠心病、房颤、心力衰竭、慢性阻塞性肺疾病、贫血、慢性肾病、营养不良、骨折、前列腺增生,年龄、患病的种数及服药的种数等比较,差异均有统计学意义(P<0.05)。在老年慢性病患者衰弱状况的多因素logistic回归分析显示:衰弱期与年龄、合并心力衰竭、房颤、慢性阻塞性肺疾病、贫血、营养不良、骨折及患病种数有关。结论老年人衰弱与慢性病有关,有针对性地加强慢性病防控对降低老年人衰弱的发生有重要作用。

Objective To investigate the prevalence and epidemiological characteristics of chronic disease-related frailty in hospitalized older patients.Methods A total of 1179 hospitalized older patients were selected.The frailty was assessed by using on-site questionnaire,physical examination and frail scale.The influential factors of frailty were analyzed.Results The sequence of prevalence of chronic diseases in hospitalized older patients was coronary heart disease(68.1%),hypertension(67.7%),stroke(54.4%),malnutrition(42.3%),chronic obstructive pulmonary disease(34.7%),diabetes(24.2%).There were significant differences in the prevalence of coronary heart disease,atrial fibrillation,chronic obstructive pulmonary disease(COPD),malnutrition,prostatic hyperplasia,cataract and fracture among different age groups(P<0.05).There were significant differences in the number of diseases and the number of drugs taking among different age groups(P<0.05).There were 291(24.7%)patients without frailty,319(27.1%)patients with pre-frailty and 569(48.3%)patients with frailty in the patients.The univariate analysis of different frailty levels showed that there were significant differences in the comparison between whether combined with coronary heart disease,atrial fibrillation,heart failure(COPD),anemia,chronic kidney disease,malnutrition,fracture prostatic hyperplasia,different age groups,number of diseases and number of medications(P<0.05).Multivariate logistic regression analysis of frailty in older patients with chronic diseases showed that age,heart failure,atrial fibrillation,COPD,anemia,malnutrition,fracture and the number of diseases were related to the level of frailty.Conclusion Frailty in older people might be related to chronic diseases.Prevention and control of chronic diseases would play an important role in reducing the occurrence of frailty in older people.