老年共病住院患者衰弱风险预测模型的构建及验证

Construction of frailty risk prediction model for elderly inpatients with comorbidity and its validation

目的探讨影响老年共病住院患者发生衰弱的危险因素,构建并验证衰弱风险预测模型。方法采用便利抽样法,选取2021年1月-2022年6月就诊于我院的老年共病住院患者300例,将其中2021年1-12月的200例老年共病住院患者的临床资料进行统计并分析衰弱的危险因素,利用logistic回归构建风险预测模型,并使用列线图展示模型;选择2022年1-6月的100例患者数据,利用ROC曲线对模型进行验证。结果200例老年共病住院患者中,发生衰弱59例,发生率为29.5%。回归分析显示:年龄、营养状况、BMI、体育锻炼、合并疾疾数量、慢性疼痛、胃肠道症状慢性疼痛是老年共病住院患者衰弱的影响因素。最终构建的预测模型的ROC曲线下面积为0.844(95%CI为0.801~0.888),灵敏度为91.4%,特异度为75.3%,最大Youden指数0.667。结论本研究构建的老年共病住院患者衰弱风险预测模型预测效果较好,可为临床护理人员识别高危患者并及时干预提供指导。

Objective To explore the risk factors of frailty in elderly inpatients with comorbidity,and to construct and verify a frailty risk prediction model.Methods From January 2021 to June 2022,convenience sampling was used to select 300 elderly inpatients with comorbidity in our hospital.The clinicalrelated data of 200 elderly inpatients with comorbidity from January to December 2021 were statistically analyzed and the risk factors of frailty were analyzed.Logistic regression was used to construct the risk prediction model,and a nomograph was used to demonstrate the model.The data of 100 patients from January to June 2022 were selected to verify the model using the ROC curve.Results Among 200 elderly patients with comorbidity,frailty occurred in 59 cases(29.5%).Regression analysis showed that age,nutritional status,BMI,physical exercise,number of diseases,chronic pain,gastrointestinal symptoms were the factors affecting the debilitation of senile comorbidities.The area under the ROC curve of the final prediction model was 0.844(95%CIwas 0.8010.888),the sensitivity was 91.4%,the specificity was 75.3%,and the maximum Youden index was 0.667.Conclusions The prediction effect of the frailty risk prediction model for elderly inpatients with comorbidities constructed in this study is good,which can provide guidance for the identification of highrisk patients and timely intervention strategies.