Kihon老年衰弱筛查量表评估老年住院病人衰弱的有效性

Effectiveness of Kihon Checklist in assessing frailty in hospitalized elderly patients

目的 探讨Kihon老年衰弱筛查量表在老年住院病人中的临床应用价值。方法 采用便利抽样法选取2021年9月至2022年5月北京协和医院住院的300例老年病人为研究对象,所有病人入院后3 d内均完成老年综合评估,分别采用Fried衰弱表型和Kihon老年衰弱筛查量表进行衰弱评估。结果 300例研究对象平均年龄为(77.97±9.08)岁,Fried衰弱表型筛查出衰弱病人122例(40.67%);Kihon老年衰弱筛查量表检出衰弱病人144例(48.00%)。Fried衰弱表型与Kihon老年衰弱筛查量表一致性检验的Kappa值为0.745(P<0.01)。Spearman相关分析显示,Kihon老年衰弱筛查量表得分与MMSE、简易微型营养评定法(MNA-SF)、Barthel指数评定量表、Lawton Brody指数得分呈负相关(r=-0.449、-0.542、-0.444、-0.730,P均<0.01),与查尔森合并症指数呈正相关(r=0.353,P<0.01)。ROC曲线分析显示,Kihon老年衰弱筛查量表评估老年住院病人衰弱的AUC为0.960,灵敏度为0.831,特异度为0.934,最佳临界值为9分。结论 Kihon老年衰弱筛查量表是一种快速、简便、灵敏的筛查方法,可有效评估老年住院病人衰弱,并指导医护人员给予衰弱老年人相应的支持。

Objective To explore the clinical application value of Kihon Checklist in hospitalized elderly patients.Methods Three hundred elderly patients hospitalized in Peking Union Medical College Hospital from September 2021 to May 2022 were selected as the study subjects by convenient sampling method.All the patients completed comprehensive geriatric assessment within 3 days after admission,and were assessed with Fried frailty phenotype and Kihon Checklist respectively.Results The average age of the 300 elderly was 77.97±9.08 years old.A total of 122 patients with frailty(40.67%)were screened using Fried frailty phenotype,and 144 patients with frailty(48.00%)were screened using Kihon Checklist.The Kappa value of the consistency test between Fried frailty phenotype and Kihon Checklist was 0.745(P<0.01).Spearman correlation analysis showed that the score of Kihon Checklist was negatively correlated with the scores of Mini-Mental State Examination(MMSE),Short Form Mini-Nutrition Assessment(MNA-SF),Barther index and Lawton Brody index(r=-0.449,-0.542,-0.444,-0.730,all P<0.01),and positively correlated with Charlson complication index(r=0.353,P<0.01).Receiver operating characteristic curve showed that the area under the curve for assessing frailty in elderly hospitalized patients using Kihon Checklist was 0.960,with a sensitivity of 0.831 and a specificity of 0.934,and the cut-off value was 9 points.Conclusions Kihon Checklist is fast,simple,and sensitive in screening frailty in hospitalized elderly patients,and it can guide medical staff to provide corresponding support to elderly patients with frailty.