长寿老年人慢性病及共病状态调查

Survey of chronic diseases and comorbidity status in long-lived elderly

目的调查长寿老年患者(≥90岁)慢性病及共病状态,为老年患者慢性病共病管理提供依据。方法统计2017年1月至12月东部战区总医院老年病研究中心保障的172例≥90岁老年患者的疾病信息,筛选出25种患病率最高的慢性病(包括老年综合征),对慢性病及共病特点进行统计分析。采用SPSS 24.0软件进行数据分析。根据数据类型,组间比较分别采用t检验及χ^(2)检验。logistic回归分析比较疾病对实际患病率与理论患病率。结果156例(90.70%)长寿老年患者合并2种及以上慢性病,平均(6.53±3.69)种,慢性病检出率前5位的慢性病为高血压128例(74.42%)、脑血管病123例(71.51%)、冠心病91例(52.91%)、骨关节病78例(45.35%)及糖尿病70例(40.70%)。慢性病两两组合成疾病对,疾病对检出率前5名的分别是:高血压/良性前列腺增生80例(64.00%)、高血压/脑血管病98例(56.98%)、脑血管病/良性前列腺增生64例(51.20%)、高血压/冠心病85例(49.42%)、脑血管病/骨关节病72例(41.86%)。高血压/冠心病、高血压/良性前列腺增生、冠心病/心功能不全的实际患病率高于理论患病率[(OR=2.452,95%CI 1.570~3.831);(OR=2.757,95%CI 1.652~4.602);(OR=2.024,95%CI 1.249~3.280)],差异均有统计学意义(均P<0.05)。结论长寿老年患者慢性病检出率高且普遍存在多病共存,多种慢性病存在相关关系。

Objective To investigate the chronic diseases and comorbidity status in long-lived elderly(aged 90 years or older)in order to provide evidence for the management of multimorbidity in the patients.Methods Clinical data of 172 aged 90 years and over patients in the Research Center for Geriatrics of our hospital from January to December 2017 were collected and analyzed.Based on the presence of 25 most common chronic diseases(including geriatric syndrome),these chronic diseases and characteristic of multimorbidity were investigated.SPSS statistics 24.0 was used for statistical analysis.Intergroup comparison was performed with student′s t test or Chisqaure test depending on data type.Logistic regression analysis was adopted to analyze the actual and theoretical prevalence of diseases.Results Among the subjects,156(90.70%)of them had 2 or more comorbidities,with a mean number of(6.53±3.69).In the 25 screened chronic diseases,the top 5 with the highest prevalence were hypertension(128 cases,74.42%),cerebrovascular disease(123 cases,71.51%),coronary heart disease(91 cases,52.91%),bone and joint disease(78 cases,45.35%)and diabetes(70 cases,40.70%).When 2 comorbidities were combined into a disease pair,the top 5 disease pairs were hypertension/benign prostatic hyperplasia(80 cases,64.00%),hypertension/cerebrovascular disease(98 cases,56.98%),cerebrovascular disease/benign prostatic hyperplasia(64 cases,51.20%),hypertension/coronary heart disease(85 cases,49.42%),and cerebrovascular disease/bone and joint disease(72 cases,41.86%).The observed prevalence of specific disease pairs was higher than the expected prevalence,including hypertension/coronary heart disease(OR=2.452,95%CI 1.570-3.831),hypertension/benign prostatic hyperplasia(OR=2.757,95%CI 1.652-4.602),and coronary heart disease/cardiac insufficiency(OR=2.024,95%CI 1.249-3.280)(all P<0.05).Conclusion The incidence of chronic diseases and multimorbidity is quite high in long-lived elderly patients,and these multiple chronic conditions are associated.