Edmonton衰弱量表和Groningen衰弱指标在养老机构老年人衰弱评估中应用的比较

Comparison of the Edmonton Frailty Scale and the Groningen Frailty Indicator in the assessment of frailty among elderly in nursing homes

目的:比较Edmonton衰弱量表(EFS)和Groningen衰弱指标(GFI)对养老机构老年人衰弱的筛查能力。方法:采用便利抽样法选取2020年5月—9月温州市8家养老机构的216例老年人为研究对象,采用一般资料调查表、衰弱表型(FP)、EFS、GFI进行资料收集;以FP为诊断标准,通过ROC曲线和Bayes判别分析比较EFS和GFI的评估能力。结果:FP、EFS、GFI评估衰弱的发生率分别为35.2%、40.3%、43.1%;EFS、GFI与FP筛查结果一致性检验Kappa值分别为0.460与0.430(均P<0.001);以FP为参照,EFS和GFI的ROC曲线下面积分别为0.805和0.801,面积差为0.004(Z=0.090,P=0.894),EFS和GFI的灵敏度分别为0.711和0.645,最佳临界值均为4.5;EFS和GFI的交叉验证准确率分别为74.5%和72.7%。结论:EFS与GFI均可应用于养老机构老年人的衰弱评估,二者的筛查能力均为中等,EFS的灵敏度高于GFI,更适用于养老机构老年人的衰弱筛查。

Objective:To compare the frailty screening ability of the Edmonton Frailty Scale(EFS)and Groningen Frailty Indicator(GFI)among elderly people in nursing homes.Methods:A convenience sampling method was used to select 216 elderly people from 8 elderly institutions in Wenzhou from May to September 2020 for the study,and data were collected by using the general condition questionnaire,Frailty Phenotype(FP),EFS and GFI.The assessment ability of EFS and GFI were compared by ROC curve and Bayes discriminant analysis using FP as criteria.Results:The incidence of frailty was 35.2%,40.3%and 43.1%for FP,EFS and GFI,respectively;the Kappa values of the consistency test between EFS and FP,GFI and FP were 0.460 and 0.430(both P<0.001);the ROC curves under the EFS and GFI,using FP as the reference area was 0.805 and 0.801,respectively,with an area difference of 0.004(Z=0.090,P=0.894),the sensitivity of EFS and GFI was 0.711 and 0.645,and the best critical value was 4.5 for both;the cross-validation accuracy was 74.5%and 72.7%for EFS and GFI,respectively.Conclusion:Both EFS and GFI can be applied to the frailty assessment of the elderly in nursing homes,and the similarity of screening ability between the two scales is moderate.EFS has higher sensitivity than GFI and is more suitable for frailty screening of elderly people in nursing homes.