北京某社区老年心房颤动患者的衰弱检出率及其相关因素

Related factors and prevalence for frailty in elderly people with atrial fibrillation in one community of Beijing

目的分析衰弱在社区老年心房颤动患者中的检出率及其相关因素。方法选取2015年7月1日至2019年12月31日在北京某社区居住的年龄≥65岁的老年心房颤动患者共121例。根据Fried衰弱表型评估衰弱后,分为非衰弱及衰弱组,分析不同年龄及不同类型心房颤动衰弱发生差异,并采用logistic回归分析老年心房颤动患者发生衰弱的相关因素。结果在121例老年心房颤动患者中,衰弱检出率为18.2%(22例),阵发性心房颤动、持续性心房颤动、永久性心房颤动患者中衰弱检出率分别为18.1%、19.0%、17.6%,3种心房颤动类型之间衰弱检出率差异无统计学意义。Fried表型5种组分的检出率由高到低分别为握力下降66.1%(80例)、步速减慢33.1%(40例)、疲乏感24.0%(29例)、活动量减少24.0%(29例)、体重减轻13.2%(16例)。衰弱组与非衰弱组相比,年龄高及合并症数量>5种比例增加,微型营养评估简易法(MNA-SF)评分及Barthel指数分值均降低,每日主动活动时间<30 min比例增多。多因素logistic回归分析显示:增龄(OR=1.225)、共病数量>5种(OR=4.915)、每日主动活动时间<30 min(OR=4.256)与老年心房颤动患者发生衰弱正相关。MNA-SF营养状态评分增加(OR=0.622)及Barthel指数评分增加(OR=0.878)与老年心房颤动患者发生衰弱负相关。结论社区老年心房颤动患者的衰弱发生率较高,衰弱与增龄、共病数量、MNA-SF营养状态评分、Barthel指数评分及每日较少活动时间相关。

Objective To investigate the prevalence of frailty among elderly patients with atrial fibrillation and search for related clinical factors.Methods A total of 121 community-dwelling elderly patients with known AF were enrolled between July 1,2015 and December 31,2019 in the study.Frailty was assessed using the Fried phenotype.The patients were classified as frail and non-frail.To analyze the differences in the frailty of atrial fibrillation in different ages and different types.Logisticre gression analysis was used to analyze the influencing factors of frailty for elderly patients with atrial fibrillation.Results There were 18.2%(n=22)frail patients in the study.The detection rates of frailty in paroxysmal,persistent and permanent atrial fibrillation patients were 18.1%,19.0%and 17.6%,respectively.There was no statistical difference in the frailty detection rates among the three types of atrial fibrillation.The detection rate of the five domains of Fried phenotype from high to low in the frailty patients were 66.1%(n=80)weak grip strength,33.1%(n=40)slow gait speed,24.0%(n=29)exhaustion,24.0%(n=29)lower physical activity and unintentional weight loss 13.2%(n=16),respectively.Frail patients were older,more likely to have more than 5 comorbidities,lower MNA-SF score,lower Barthel index and the proportion of main daily activity time<30 minutes per day increased as compared with non-frail patients.Stepwise multivariate binary logistic regression analysis revealed that aging(OR=1.225),more than 5 comorbidities(OR=4.915)and main daily activity time<30 minutes(OR=4.256)were positively correlated with frailty in elderly patients with AF.While MNA-SF(OR=0.622)and Barthel index(OR=0.878)were negatively correlated with frailty.These were the related factors with frailty inelderly patients with AF.Conclusions Prevalence of frailty is high among community-dwelling elderly patients with AF.Age,comorbidities,MNA-SF,less main daily activity time and Barthel index are related factors of frailty.