高龄患者术前衰弱现状及其影响因素分析

Analysis of Preoperative Frailty and Its Influencing Factors in Elderly Patients

目的调查高龄患者术前衰弱情况及其影响因素。方法对2022年1月—2022年6月烟台毓璜顶医院年龄≥80岁择期全麻手术患者261例进行横断面研究,采用衰弱问卷(FRAIL scale)将患者分为衰弱组､非衰弱组,采用老年综合评估量表对患者进行评估,分析两组患者的性别､年龄､文化程度､体质量指数(body mass index,BMI)､吸烟､饮酒､多病共存､营养风险､认知功能､抑郁､日常生活能力(ADL)之间的差异。根据数据类型,采用χ^(2)检验进行组间比较,采用多因素logistic回归分析进行衰弱的影响因素分析。结果高龄患者的术前衰弱程度在年龄､性别､文化程度､BMI､多病状态､营养风险､认知功能､抑郁､日常生活能力方面存在统计学差异(P<0.05)。多因素logistic回归分析显示,女性､共病､认知功能障碍和日常行为能力受损是高龄患者衰弱发生的危险因素(P<0.05)。结论高龄患者术前衰弱发生率高,且与认知功能､共病状态､日常生活能力等多个老年问题密切相关,应进行术前综合评估,筛查危险因素进行术前优化,提高其术后的生活质量和功能状态。

Objective To investigate the preoperative frailty and its influencing factors in elderly patients undergoing surgery.Methods A cross-sectional study was conducted on 261 elderly patients,aged≥80 years old,undergoing elective surgery under general anesthesia in Yantai Yuhuangding Hospital from January 2022 to June 2022.All patients were divided into frailty group and non-frailty group by FRAIL frailty scale,and evaluation level by Comprehensive Geriatric Assessment Scales.The differences of gender,age,education level,body mass index(BMI),smoking,drinking,coexistence of multiple diseases,nutritional risk,cognitive function,depression,and activities of daily were analyzed.Results There were significant differences in age,gender,education level,BMI,multi-disease status,nutritional risk,cognitive function,depression and daily living ability between two groups(P<0.05).The multivariate Logistic regression analysis showed that female,multi-disease status,cognitive dysfunction and impaired daily behavior ability were risk factors for frailty in elderly patients undergoing surgery(P<0.05).Conclusion The incidence of preoperative frailty is high in elderly patients,and it is closely related to cognitive function,comorbidity,activities of daily living and other geriatric problems.Comprehensive preoperative evaluation should be conducted to screen risk factors for preoperative optimization,so as to improve their quality of life and functional status after surgery.