慢性病共病老年住院患者衰弱评分对护理不良事件的预测价值研究

Study on the predictive value of frailty score for nursing adverse events in elderly inpatients with chronic comorbid diseases

目的 探讨老年慢病共病住院患者衰弱评分对护理不良事件的预测价值。方法 采用便利抽样的方法,选取于2020年3月-2021年1月在四川省内5所三级甲等综合医院内科住院治疗的老年慢性病共病住院患者作为研究对象,根据患者住院期间是否发生衰弱将患者分为无衰弱组、衰弱前期组和衰弱组,采用logistic回归分析慢病共病老年住院患者衰弱对护理不良事件发生的预测价值。结果 共纳入患者2 650例,衰弱分期各组占比为无衰弱(14.19%)、衰弱前期(59.32%)、衰弱(26.49%),共发生不良事件329例,无衰弱、衰弱前期、衰弱组护理不良事件发生率依次为12.77%、9.67%、18.38%。logistic回归分析显示,模型2在校正年龄、性别、BMI混杂因素后,衰弱前期组和衰弱组患者护理不良事件的发生风险分别是无衰弱组的1.541倍和2.099倍;模型3在校正年龄、性别、BMI、多重用药后,衰弱前期组和衰弱组患者护理不良事件事件的发生风险分别是无衰弱组的1.552倍和2.023倍。结论 衰弱是导致老年慢病共病住院患者护理不良事件发生的重要原因,将衰弱评估纳入患者病情评估内容,可协助临床医护人员识别患者衰弱程度,制定个性化的治疗及护理计划,及时发现并减少护理不良事件的发生。

Objective To explore the predictive value of frailty score for nursing adverse events in elderly patients with chronic disease comorbidity.Methods Using the convenient sampling method,the elderly inpatients with chronic diseases who were hospitalized in the internal medicine department of 5 third-grade grade A general hospitals in Sichuan province from March 2020 to January 2021 were selected as the research objects.The patients were divided into the non-asthenia group,the pre-asthenia group,and the asthenia group according to whether they suffered frailties during hospitalization.The predictive value of frailty for nursing adverse events in senile inpatients with chronic comorbid diseases was analyzed by logistic regression.Results A total of 2,650 patients were included,and the proportion of patients in the asthenia stage group was non-asthenia(14.19%),pre-asthenia(59.32%),and asthenia(26.49%).A total of 329 cases of adverse events occurred.The incidence of adverse events in the non-asthenia,pre-asthenia,and asthenia groups was 12.77%,9.67%,and 18.38%,respectively.The results of logistic regression analysis showed that after adjusting for age,gender,and body mass index(BMI)confounding factors in model 2,the risk of adverse nursing events in the pre-asthenia group and the asthenia group was 1.541 times and 2.099 times higher than that in the non-asthenia group,respectively.After adjusting for age,gender,BMI,and multiple drug use in model 3,the risk of adverse nursing events in the pre-asthenia group and the asthenia group was 1.552 times and 2.023 times higher than that in the non-asthenia group,respectively.Conclusion Frailty is an important cause of nursing adverse events in elderly patients with chronic disease comorbidities.Including frailty assessment into patient condition assessment can assist clinical medical staff to identify the degree of frailty of patients,develop personalized treatment and nursing plans,and timely discover and reduce the occurrence of nursing adverse events.