老年2型糖尿病住院患者衰弱相关因素分析

Related factors of frailty in elderly inpatients with type 2 diabetes mellitus

目的探讨老年2型糖尿病住院患者合并衰弱的相关影响因素。方法选择2019年5月至2020年5月广州市第一人民医院老年病科收治≥60岁老年2型糖尿病住院患者105例,根据衰弱筛查量表(FRAIL)分组,采用病例对照研究方法,将患者分为衰弱组、衰弱前期组及非衰弱组,对比组间的临床资料及数据,分析老年2型糖尿病患者发生衰弱的影响因素。结果本研究共纳入患者105例,其中男59例,女46例,年龄(84.75±7.13)岁,衰弱发生率为56.2%(59/105),衰弱患者的年龄、住院时间、1年内再住院情况、合并心脑血管疾病、合并糖尿病并发症、基本生活活动能力评定量表(BADL)评分、简易智能精神状态检测量表(MMSE)评分、维生素D(VitD-T)、白蛋白(ALB)、血红蛋白(HGB)等指标与非衰弱患者比较差异均有统计学意义(均P<0.05),而其中高龄(OR=1.105,95%CI 1.002~1.219)、MMSE评分(OR=0.136,95%CI 0.068~0.815)及BADL评分下降(OR=0.065,95%CI 0.006~0.723)、住院时间长(OR=1.631,95%CI 1.258~2.114)、VitD-T水平下降(OR=0.918,95%CI 0.854~0.987)、ALB水平下降(OR=0.790,95%CI 0.655~0.953)、HGB水平下降(OR=0.898,95%CI 0.819~0.984),均为发生衰弱的独立危险因素(均P<0.05)。结论老年2型糖尿病住院患者衰弱发生率高,1年内再入院风险升高,高龄、MMSE评分及BADL评分下降、住院时间延长、低VitD-T水平、低HGB及低ALB均为发生衰弱的独立危险因素,临床上应强调早期风险评估,并针对危险因素进行及早干预。

Objective To investigate the related factors of frailty in elderly patients with type 2 diabetes mellitus.Methods One hundred and five elderly patients with type 2 diabetes mellitus,who were older than 60 years old and treated at Department of Geriatrics,Guangzhou First People's Hospital,were selected.According to the FRAIL scale,the patients were divided into a frailty group,a pre-frailty group,and a no-frailty group.The case control study method was used.The clinical information and data compared between the groups.The related factors of frailty were analyzed.Results One hundred and five patients were included,including 59 males and 46 females,and they were(84.75±7.13)years old.The incidence of frailty was 56.2%(59/105).There were statistical differences in age,hospital stay,re-hospitalization rate within 1 year,being complicated with cardiovascular and cerebrovascular diseases,diabetic complications,Basic Activities of Daily Living(BADL)and scores of Mini-Mental State Examination(MMSE),Vitamin D(VitD-T),albumin(ALB),hemoglobin(HGB),and other indicators between the frailty group and the no-frailty group(all P<0.05).High age(OR=1.105,95%CI 1.002-1.219),low MMSE score(OR=0.136,95%CI 0.068-0.815),low BADL score(OR=0.065,95%CI 0.006-0.723),the long hospital stay(OR=1.631,95%CI 1.258-2.114),decreased VitD-T level(OR=0.918,95%CI 0.854-0.987),decreased ALB level(OR=0.790,95%CI 0.655-0.953),and decreased HGB level(OR=0.898,95%CI 0.819-0.984)were influencing factors of frailty(all P<0.05).Conclusions The incidence of frailty is high in elderly inpatients with type 2 diabetes mellitus.They have an increased chance of being readmitted within 1 year.High age,low MMSE and BADL scores,long hospital stay,and low levels of VitD-T,HGB and ALB are independent risk factors of frailty.We should emphasize the early assessment of their frailty risk and the early intervention for these risk factors.