老年慢性阻塞性肺疾病患者急性加重再入院现况及影响因素研究

Status Quo and Its Influencing Factors of Readmission for Acute Exacerbation in Elderly Patients with Chronic Obstructive Pulmonary Disease

目的调查老年慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)患者急性加重再入院的现况及影响因素。方法2018年12月至2019年3月,便利抽样法选取北京市7所医院的215例住院老年COPD患者为研究对象。采用一般资料调查问卷、功能共患病指数、改良版英国医学研究委员会呼吸问卷、简易精神状态评价量表、患者健康问卷简版、临床衰弱量表等工具对其进行调查,于6个月后随访调查其是否急性加重再入院,并分析影响因素。结果6个月内再入院次数≥1次的患者55例(25.6%);低体重、合并症多、过去1年急性加重次数≥2次为患者6个月内急性加重再入院的危险因素,差异均有统计学意义(均P<0.05)。结论老年COPD患者6个月内急性加重再入院的风险较高,医护人员应该重点关注低体重、合并症多、过去1年急性加重次数≥2次的患者,并根据患者的个体情况定期随访监测。

Objective To explore the status quo and influencing factors of readmission for acute exacerbation in elderly patients with Chronic Obstructive Pulmonary Disease(COPD).Methods Baseline data were collected from December 2018 to March 2019,and hospitalized elderly patients with COPD were recruited from the 7 hospitals in Beijing by convenience sampling method.The general information questionnaire,FCI,mMRC,MMSE,PHQ-2,and CFS instruments were used to conduct a survey.The patients were followed up 6 months to investigate whether the elderly patients were readmitted for acute exacerbation and analyze the influencing factors of readmission.Results A total of 215 patients completed the survey.The number of elderly patients who have readmitted≥1 was 55,accounting for 25.6%.Binary logistic regression showed that patients with underweight,more comorbidities,acute exacerbations≥2 in the past 1 year were risk factors of readmission for acute exacerbation in patients within 6 months.(all P<0.05).Conclusions Elderly patients with COPD are at higher risk of readmission within 6 months for acute exacerbations.Medical staffs should pay more attention to patients with underweight,more comorbidities,AECOPD≥2 in the past 1 year.Regular follow-up monitor is necessary for each patient with specific medical condition.