老年住院患者衰弱现状及相关因素分析

Analysis of frailty status and related factors in elderly inpatients

目的了解老年住院患者衰弱的现状并分析相关因素,有助于临床决策及制定针对性的干预措施。方法选取中国科学技术大学附属第一医院老年医学科189例住院患者病历资料进行回顾性队列研究,依据衰弱筛查量表(FRAIL)将研究对象分为无衰弱组、衰弱组,分别收集两组的一般资料、实验室检验数据、量表评估结果。结果189例老年住院患者中,衰弱组81例(42.9%),无衰弱组108例(57.1%)。不同年龄、性别、慢性病情况、用药种类、体重指数(BMI)的患者,衰弱患病率差异有统计学意义。衰弱组具有更多日常生活活动能力下降、压疮风险、高跌倒风险、高危静脉血栓形成风险、营养不良患者。二分类多因素回归分析结果显示C反应蛋白(CRP)升高(OR=1.187,95%CI:1.097~1.284)、日常生活活动能力(ADL)受损(OR=5.270,95%CI:1.089~25.504)、压疮风险(OR=6.587,95%CI:1.192~36.404)是衰弱发生的危险因素,高血清铁水平(OR=0.854,95%CI:0.786~0.928)、高25羟维生素D水平(OR=0.822,95%CI:0.743~0.911)是老年住院患者衰弱发生的保护因素(P<0.05)。结论老年住院患者衰弱发生率高,CRP升高、ADL受损、压疮风险与老年住院患者衰弱的发生密切相关。

Objective To understand the status of fattening in elderly hospitalized patients and analyze the related factors,in order to help clinical decision-making and the formulation of targeted intervention measures.Methods A retrospective cohort study was conducted on 189 inpatients in geriatrics department of the First Affiliated Hospital of USTC,and on the basis of the FRAIL scale,study subjects were classifyed into a non-frailty group and a frailty group.General information,lab-oratory test data,and scale evaluation results of the two groups were collected,respectively.Results Among 189 elderly hospitalized patients,81were in the frailty group,accounting for 42.9%,and 108 were in the nonfrailty group,accounting for 57.1%.There was statistical difference in frailty prevalence among patients with different age,gender,ch-ronic disease,type of medication and BMI.The frailty group had more patients with decreased ability of daily living activities,high risk of pressure ulcers,high risk of falls,high risk of venous thrombosis,and malnutrition.The resultsofbinary multivariateregression analysisshowed increased C-reactive protein(OR=1.187,95%CI:1.097-1.284),impaired ADL ability(OR=5.270,95%CI:1.089-25.504),and pressure ulcer risk(OR=6.587,95%CI:1.192-36.404)are risk factors for frailty,High serum iron level(OR=0.854,95%CI:0.786-0.928),high25 hydroxyvitamin D level(OR=0.822,95%CI:0.743-0.911)were associated with frailty in elderly hospitalized patients P<0.05.Conclusions The incidence of senile inpatients with frailty is high,CRP elevation,ADL damage,pressure ulcer risk are closely related to the occurrence of senile inpatients with frailty.