高龄住院患者衰弱现状及影响因素分析

Status and risk factors of frailty in senile inpatients

目的探讨高龄住院患者的衰弱现况和衰弱发生的影响因素。方法选取广州市某三甲医院的高龄住院患者168例作为研究对象。运用基本资料调查表、衰弱影响因素调查表、Barthel指数、简易机体功能评估、NRS-2002营养评估表、简易精神状态检查量表、PHQ-9抑郁自评量表和GAD-7焦虑自评量表进行调查研究,同时运用Fried衰弱表型量表对高龄住院患者进行衰弱状态的评估。结果168例患者中发生衰弱者71例(占42.2%),衰弱前期为48例(占28.6%),未发生者49例(占29.2%)。speraman系数相关性分析显示,衰弱的发生与规律运动、SPPB存在负相关关系;与年龄、共病、多重用药、营养不良、认知障碍、自理能力障碍、焦虑和抑郁存在正相关关系。结论高龄患者更易发生衰弱,运动可以改善衰弱的状态,衰弱与多重用药、共病的相关性极高,存在焦虑、抑郁等负性心理更易发生衰弱。在临床工作中可以针对以上因素采取针对性的措施降低不利因素的影响,改善或逆转衰弱的发生。

Objective To investigate the status and influencing factors of frailty in senile inpatients.Methods A total of 168 senile inpatients in a tertiary hospital in Guangzhou were enrolled in the survey by using the basic data questionnaire,frailty influencing factor questionnaire,Activity of Daily Living Scale,Short Physical Performance Battery(SPPB),Nutritional Risk Screening and Assessment,Mini-mental State Examination,Patient Health Questionnaire-9 and Generalized Anxiety Disorder-7 were used to conduct a comprehensive investigation.Their frailty was assessed by the Fried frailty phenotype.Results The frequency of frailty was 42.2%among the senile inpatients.The frequency of pre-frailty was 28.6%.By Spearman’s Rank Correlation Coefficient,the frailty was negatively correlated with regular exercise and SPPB and positively correlated with age,comorbidities,multiple medications,malnutrition,cognitive impairment,self-care dysfunction,anxiety and depression.Conclusion Senile inpatients have a high incidence of frailty.Physical exercises can improve the state of frailty.Frailty is highly correlated with multiple medications.Those with negative psychology such as anxiety and depression are more prone to frailty.In clinical situations,targeted measures must be taken to reduce the impact of unfavorable factors and improve or reverse the occurrence of frailty.