基于老年综合评估的衰弱指数对缺血性脑卒中患者衰弱的预测价值

Predictive value of frailty index derived from comprehensive geriatric assessment for frailty of patients with ischemic stroke

目的探讨基于老年综合评估的衰弱指数(CGA-FI)对缺血性脑卒中患者衰弱的预测价值。方法采用便利抽样法,选取2019年1月—2020年5月在北京老年医院神经内科住院的100例缺血性脑卒中患者为研究对象。采用CGA-FI对其进行调查。100例患者中2例患者在收集资料的过程中退出研究,最终98例患者完成了资料收集。结果98例缺血性脑卒中患者中,发生衰弱者占15.3%(15/98)。二项Logistic回归分析结果显示,年龄及跌倒史是缺血性脑卒中患者发生衰弱的影响因素(P<0.05)。CGA-FI预测缺血性脑卒中合并衰弱患者的受试者工作特征曲线下面积为0.796(95%置信区间:0.632~0.959,P<0.05)。结论缺血性脑卒中患者衰弱发生率处于较高水平。年龄及跌倒史是缺血性脑卒中患者发生衰弱的影响因素。CGA-FI对缺血性脑卒中患者发生衰弱的预测准确性较高,提示医护人员应将CGA-FI应用于临床实践中,为患者提供最优的诊疗护理方案,将衰弱的防治关口前移。

Objective To explore the predictive value of the frailty index derived from comprehensive geriatric assessment(CGA-FI)for the frailty of patients with ischemic stroke.Methods From January 2019 to May 2020,convenience sampling was used to select 100 patients with ischemic stroke in the Department of Neurology,Beijing Geriatric Hospital.The CGA-FI was used for investigation.Among the 100 patients,two patients withdrew from the study during the data collection process,and finally 98 patients completed the data collection.Results Among 98 patients with ischemic stroke,patients with frailty accounted for 15.3%(15/98).Binomial Logistic regression analysis showed that age and history of falls were the influencing factors of ischemic stroke patients were with frailty(P<0.05).The area under the curve(AUC)of CGA-FI for predicting ischemic stroke patients with frailty was 0.796(95%confidence interval:0.632-0.959;P<0.05).Conclusions The incidence of frailty in patients with ischemic stroke is at a high level.Age and history of falls are the influencing factors of ischemic stroke patients are with frailty.CGA-FI has a high accuracy in predicting frailty in patients with ischemic stroke.Medical and nursing staff should apply CGA-FI in clinical practice to provide patients with the best diagnosis and treatment nursing plan,and move the frailty prevention and treatment threshold forward.