步速与住院高龄老年患者全因死亡的相关性  

Correlation of gait speed with all-cause mortality in very old inpatients

作　　者：杨卉[1] 王青[1] 路菲 孔建华[1] 崔云婧 YANG Hui;WANG Qing;LU Fei;KONG Jian-Hua;CUI Yun-Jing(Department of Comprehensive Medicine, FuxingHospital, Capital Medical University, Beijing 100038, China)

机构地区：[1]首都医科大学附属复兴医院综合科,北京100038

出　　处：《中华老年多器官疾病杂志》2021年第5期332-336,共5页Chinese Journal of Multiple Organ Diseases in the Elderly

基　　金：北京市西城区卫生健康委员会科技新星项目(XWKX2020-23)。

摘　　要：目的探讨步速与住院高龄老年患者全因死亡的相关性。方法选择2015年6月至2017年12月在首都医科大学附属复兴医院综合科住院且年龄≥80岁的患者510例,记录患者基本资料、共病及多重用药情况,采用Katz日常生活能力量表(Katz-ADL)、简易智能评估量表(MMSE)、微型营养评定法简表(MNA-SF)、抑郁自评量表(SDS)评估日常生活活动能力、认知状况、营养状态及抑郁状况,采用6米步行试验计算步速,出院随访2年以上并记录患者全因死亡的发生情况。采用SPSS 21.0统计软件进行分析。Spearman相关系数分析步速与各变量之间的相关性,Kaplan-Meier曲线和Cox回归模型分析步速与全因死亡风险的相关性。结果共入选患者499例,年龄(86.3±4.1)岁,其中男性298例(59.7%),中位随访3.3(2.7,3.9)年,随访期间共118例(23.6%)发生全因死亡。Spearman相关分析显示,步速与年龄、Charlson共病指数呈负相关(r=-0.352、-0.196、-0.124,P<0.05),与Katz-ADL、MMSE及MNA-SF评分呈正相关(r=0.430、0.291、0.273,P<0.05)。将步速三分位数分组,Kaplan-Meier曲线显示随着步速下降,全因死亡风险逐渐升高(P<0.001);Cox回归模型结果显示,在调整混杂因素后,与最高步速组相比,其他2组全因死亡风险更高(中等步速组:HR=2.365,95%CI 1.231~4.541,P=0.010;最低步速组:HR=2.363,95%CI 1.215~4.591,P=0.011)。结论住院高龄老年患者中,低步速与出院后全因死亡风险相关,步速可作为一项简便易行的死亡预测指标。Objective To investigate the correlation between gait speed and mortality in very old inpatients.Methods A total of 510 very old inpatients(≥80 years)at our department from June 2015 to December 2017 were enrolled in this study.Their basic data,comorbidities and polypharmacy were recorded at admission.Their activities of daily living was assessed by Katz index of the Katz in activities of daily living(Katz-ADL),cognitive function by mini-mental state examination(MMSE),nutrition level by micronutrient assessment method short-form(MNA-SF),and depression status by self-rating depression scale(SDS).The gait speed was measured with 6-meter walking test.After discharge,all-cause mortality was followed up for more than 2 years and recorded.SPSS statistics 21.0 was used for data analysis.Spearman correlation coefficient was used to analyze the correlation between gait speed and variables.Kaplan-Meier survival curve and Cox regression analysis were used to analyze the correlation between gait speed and mortality.Results For the 499 inpatients,they were at a mean age of(86.3±4.1)years,and 59.7%of them were male.During a median follow-up of 3.3 years(2.7,3.9),118 participants(23.6%)died.Spearman correlation analysis revealed that gait speed was negatively correlated with age,Charlson comorbidity index(CCI)and polypharmacy(r=-0.352,-0.196,-0.124;P<0.05),and positively correlated with Katz-ADL,MMSE and MNA-SF scores(r=0.430,0.291,0.273;P<0.05).After the patients were divided into tertile groups according to gait speed,Kaplan-Meier survival analysis showed that mortality was increased with the decrease of gait speed(P<0.001).Cox regression analysis with adjustment for potential confounding variables indicated that compared with the fastest group,the other 2 groups have a higher risk of mortality(middle speed group:HR=2.365,95%CI 1.231~4.541,P=0.010;lowest speed group:HR=2.363,95%CI 1.215~4.591,P=0.011).Conclusion In elderly inpatients,low gait speed is associated with the risk of all-cause mortality.Gait speed could be a si

关 键 词：老年人 步速 住院患者 死亡 

分 类 号：R592[医药卫生—老年医学]