心脏术后老年患者的衰弱状况及影响因素分析

The analysis of the debilitating condition and influencing factors of elderly patients after cardiac surgery

目的分析探讨心脏术后老年患者的衰弱状况及影响因素。方法分别采用Fried衰弱表型测评量表、12项一般健康问卷(GHQ一12)及工具性日常生活活动能力量表(IADL)评估208例心脏术后患者的衰弱情况、心理健康状况及日常生活活动能力,并分析探讨心脏术后患者衰弱状况的影响因素。结果单因素分析发现,3组患者性别构成比、吸烟、饮酒差异无统计学意义(P>0.05)。年龄、共病、婚姻状况、经济状况、教育程度、睡眠问题、GHQ-12及IADL评分差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,年龄75岁以上、GHQ-12评分>2、IADL评分>5、有睡眠问题为衰弱前期及衰弱期共同的危险因素,月收入≤1000为衰弱前期危险因素,共病>1种、未婚、离异或丧偶、文化程度低为衰弱期危险因素。结论年龄75岁以上、GHQ-12评分>2、IADL评分>5、有睡眠问题、共病>1种、未婚、离异或丧偶、文化程度低均为心脏术后衰弱发生的危险因素,此发现可帮助医务人员早期发现衰弱综合征,并采取相关有效干预措施。

Objective To analyze the debilitating condition and influencing factors of elderly patients after cardiac surgery.Methods The weak debilitating phenotype assessment scale,12 general health questionnaires(GHQ-12)and the instrumental activity of daily living ability scale(IADL)were used to evaluate the debilitating condition,mental health status and activity ability of 208 patients after cardiac surgery and then analyze the factors affecting the debilitating condition.Results Univariate analysis showed that there was no significant difference in gender composition ratio,smoking and drinking between the three groups(P>0.05).Ages,comorbidity,marital status,economic status,education levels,sleep problems,GHQ-12 and IADL scores were statistically significant(P<0.05).Multivariate logistic regression analysis showed that age above 75 years,GHQ-12 score>2,IADL score>5,and sleep problems were the common risk factors of debilitating pre-debilitating and debilitating period,and income≤1000 per month was the pre-debilitating risk factor.Common diseases>1,unmarried,divorced or widowed,low education level were risk factors for debilitating period.Concusion Age above 75 years,GHQ-12 score>2,IADL score>5,sleep problems,comorbidity>1,unmarried,divorced or widowed,low education level were risk factors for postoperative debilitation of heart surgery which can help medical services to early detect debilitating syndrome and improve development of relevant effective interventions.