住院共病老年患者衰弱现状及其危险因素研究

Frail status and risk factors in elderly inpatients with comorbidity

目的探讨住院共病老年患者衰弱现状及其危险因素。方法采用横断面研究收集214例安徽医科大学附属省立医院收治的住院共病老年患者一般资料、Charlson共病指数(CCI)、服药种类,并评估营养及认知功能,根据衰弱筛查量表(FRAIL)将患者分为衰弱组、非衰弱组,比较2组各个指标差异,分析衰弱情况及其危险因素。结果214例患者衰弱、衰弱前期及无衰弱的发生率分别为56.1%、26.6%、17.3%。衰弱组与非衰弱组患者年龄、共病数量、CCI分级、卒中、服药种类、营养风险、认知功能障碍、红细胞、血红蛋白、总蛋白、前白蛋白、白蛋白、纤维蛋白原、D-二聚体差异有统计学意义(P<0.05);二元logistic回归分析显示:CCI分级(OR=4.877,95%CI:1.883~12.634)、营养风险(OR=3.233,95%CI:1.323~7.901)、认知功能障碍(OR=3.630,95%CI:1.400~9.416)、PAB(OR=0.989,95%CI:0.981~0.997)是住院共病老年患者发生衰弱的独立危险因素。结论住院共病老年患者衰弱发生率高,其中CCI分级高、有营养风险、认知功能障碍、低PAB是发生衰弱的重要危险因素。

Objective To explore the frailty status and risk factors of elderly inpatients with comorbidities.Methods A cross-sectional study was used to collect the general information,Charlson comorbidity index(CCI),type of medication of 214 elderly inpatients with comorbidities in Affiliated Provincial Hospital of Anhui Medical University and evaluate their nutrition and cognitive function.According to the Frailty Screening Scale(FRAIL),the patients were divided into frailty group and the non-frailty group.In addition,the differences in indicators between the two groups were compared and the frailty situation and its risk factors of them were analyzed.Results The incidence of frailty,pre-frailty and non-frailty in 214 cases were 56.1%,26.6%,and 17.3%,respectively.The differences in the age,number of comorbidities,CCI classification,stroke,type of medication,nutritional risk,cognition impairment,red blood cell(RBC),hemoglobin(HGB),total protein(TP),prealbumin(PAB),albumin(ALB),fibrinogen(FIB),D-dimer(DD)between 2 groups was statistically significant(P<0.05).Binary logistic regression analysis indicated that CCI classification(OR=4.877,95%CI:1.883-12.634),nutritional risk(OR=3.233,95%CI:1.323-7.901),cognition impairment(OR=3.630,95%CI:1.400-9.416),PAB(OR=0.989,95%CI:0.981-0.997)were independent risk factors for frailty.Conclusions The incidence of frailty is high in elderly inpatients with comorbidities.The higher CCI classification,poor nutritional risk,cognition impairment,and lower PAB levels are important risk factors for frailty.