老年心衰患者衰弱的危险因素分析

Risk Factors and Influence of Frailty in Elderly Patients with Chronic Heart Failure

目的分析合并不同并发症的老年心衰患者衰弱的发生率及危险因素。方法纳入2013-2017年在广州军区总医院住院的自愿接受调查的老年心衰患者进行问卷调查,内容包括患者的一般情况、主要合并症等,并完成衰弱的评估。最终纳入371例,年龄65~96岁,平均年龄(80.5±6.0)岁,其中男320例,女51例。结果总人群的衰弱检出率为24.0%,≥80岁的高龄老年患者衰弱检出率明显高于65~79岁的老年患者(26.4%vs 16.4%),差异有统计学意义(P<0.05);心衰合并肾功能不全、脑血管病衰弱检出率高于未合并者(均P<0.05);患者衰弱检出率随合并症数量增加而增加。多因素Logistic回归分析发现高龄、肾功能不全、脑血管病、NYHA分级为老年心力衰竭患者发生衰弱的独立危险因素(均P<0.05)。结论老年慢性心衰患者衰弱的检出率随年龄及合并症的增加而增加,高龄、肾功能不全、脑血管病、NYHA分级可能为心衰患者发生衰弱的危险因素。

Objective The aim of this study was to analysis the prevalence,risk factor of frailty in elderly patients with chronic heart failure. Methods The elderly patients with chronic heart failure in General Hospital of Guangzhou Military Command of PLA from 2013 to 2017 were enrolled in the study. The demographic characteristics and medical record data were collected. All patients received frailty assessment with Fried criteria. A total of 371 patients aged 65-96( 80. 5 ± 6. 0) years were included in this study. Result The prevalence rate of frailty was 21. 3%,with 16. 4% and 26. 4% in patients of 65-79 and ≥ 80 years respectively( P < 0. 05). The prevalence of frailty in elderly patients with chronic heart failure with renal insufficiency and cerebrovascular disease was significantly higher in with the two diseases than without( P <0. 05). The prevalence of frailty increased with the number of major complications in elderly patients with chronic heart failure. Multivariate Logistic regression analysis indicated that elderly,renal insufficiency,cerebrovascular disease and NYHA classification were significantly associated with frailty( P < 0. 05).Conclusion The prevalence rate of frailty in patients was increased with age and the number of major complications. The elderly,renal insufficiency,cerebrovascular disease and NYHA classification may be the independent risk factors for frailty in elderly patients with chronic heart failure.