老年冠心病病人衰弱发生率及其影响因素的系统评价

Incidence and influencing factors of frailty in elderly patients with coronary heart disease:a systematic review

目的:系统评价老年冠心病病人衰弱发生率及其影响因素,为开展临床干预提供循证依据。方法:系统检索中国知网、万方数据库、中国生物医学文献数据库、维普数据库、PubMed、Web of Science、EMbase、FMRS、CINAHL关于老年冠心病病人衰弱发生率及其影响因素的相关文献,检索时限为建库至2022年5月。由2名研究者按照纳入和排除标准独立进行文献筛选、质量评价和资料提取,采用Stata 15.1和RevMan 5.4软件分别进行发生率和影响因素的Meta分析。结果:共纳入21篇文献,涉及6 576例病人。Meta分析结果显示,老年冠心病病人衰弱发生率为43.3%[95%CI(0.33,0.54),P<0.001]。冠心病病人衰弱的影响因素包括年龄(增龄、高龄)、营养状况(营养不良)、缺乏运动、多病共存(合并高血压、心功能不全)、睡眠障碍、抑郁、文化程度。结论:现有证据表明,老年冠心病病人衰弱的发生率高且影响因素较多,应为病人提供针对性的护理干预,以减少衰弱的发生率,提高病人生活质量。

Objective:To systematically evaluate the incidence and influencing factors of frailty in elderly patients with coronary heart disease(CHD),and to provide evidence for clinical intervention.Methods:The relevant literature on the incidence of frailty and its influencing factors in elderly patients with coronary heart disease were retrieved from CNKI,WanFang Database,CBM,VIP,PubMed,Web of Science,EMbase,FMRSA and CINAHL.The retrieval time was from the inception to May 2022.Two researchers independently conducted literature screening,quality evaluation and data extraction according to inclusion and exclusion criteria,and used Stata 15.1 and RevMan 5.4 software to conduct Meta-analysis of incidence and influencing factors,respectively.Results:A total of 21 literature were included,including 6576 patients.The results of Meta-analysis showed that the incidence of frailty in elderly patients with CHD was 43.3%(95%CI 0.33-0.54,P<0.001).The influencing factors of frailty in patients with coronary heart disease include age(aging,advanced age),nutritional status(malnutrition),lack of exercise,coexistence of multiple diseases(combined hypertension,cardiac insufficiency),sleep disorders,depression,education level.Conclusion:Current evidence shows the incidence of frailty in elderly patients with coronary heart disease is high and there are many influencing factors.Targeted nursing intervention should be provided for patients to reduce the incidence of frailty and improve the quality of life of patients.