住院老年病人衰弱状况及影响因素分析  

The current situation and influential factors of frailty in the hospitalized elderly patients

作　　者：郭红菊 杨宜帆 高银凤 孙梓旭 柳达[2] GUO Hong-ju;YANG Yi-fan;GAO Yin-feng;SUN Zi-xu;LIU Da(Shihezi University School of Medicine,Shihezi 832000,China;Department of Geriatrics,First Affiliated Hospital,School of Medicine,Shihezi University,Shihezi 832000,China;Department of General Medicine,the First Affiliated Hospital of Hebei North University,Zhangjiakou 075061,China)

机构地区：[1]石河子大学医学院,新疆维吾尔自治区石河子市832000 [2]石河子大学医学院第一附属医院老年病科,新疆维吾尔自治区石河子市832000 [3]河北北方学院附属第一医院全科医学科,河北省张家口市075061

出　　处：《实用老年医学》2021年第9期948-952,共5页Practical Geriatrics

摘　　要：目的调查住院老年病人衰弱现状并探讨其影响因素。方法收集2019年11月至2020年6月在石河子大学医学院第一附属医院老年病科住院治疗且年龄≥65岁的病人242例,应用Fried量表评估病人的衰弱情况,分为衰弱组和非衰弱组。收集2组一般资料、实验室检查和超声心动图结果,采用二元Logistic回归分析住院老年病人衰弱的影响因素。结果2组在年龄、文化程度、住院费用、住院天数、合并疾病种类、日常生活能力(ADL)、认知功能、营养状态、跌倒/坠床风险方面差异有统计学意义(均P<0.05)。衰弱组患有CHD、CHF、脑血管病的构成比高于非衰弱组(均P<0.05)。与非衰弱组相比,衰弱组的RBC、淋巴细胞百分比、白蛋白水平降低,而中性粒细胞百分比、中性粒细胞计数、UA、肌酐、胱抑素C水平升高,且衰弱组左心房内径增大(均P<0.05)。二元Logistic回归分析显示,ADL受损(OR=7.800,95%CI2.205~27.590)、营养不良(OR=3.935,95%CI1.636~9.461)、高胱抑素C水平(OR=5.937,95%CI1.541~22.876)、左心房内径大(OR=1.069,95%CI1.001~1.141)、CHD(OR=2.299,95%CI1.087~4.864)是住院老年病人衰弱的危险因素,白蛋白高(OR=0.864,95%CI0.779~0.958)是住院老年病人衰弱的保护因素。结论住院老年病人衰弱发生率高,建议医务人员重视住院老年病人衰弱的评估,并针对可控危险因素进行有效干预。Objective To investigate the current situation of frailty and explore its influencing factors in the hospitalized elderly patients.Methods A total of 242 patients aged 65 and over who were hospitalized in the Department of Geriatrics of the First Affiliated Hospital,School of Medicine,Shihezi University from November 2019 to June 2020 were collected and divided into frailty group and non-frailty group according to the results of Fried Frailty Phenotype.The general data,laboratory indicators and echocardiographic results of the two groups were collected.Binary Logistic regression analysis was used to analyze the influencing factors of frailty in the hospitalized elderly patients.Results There were significant differences in age,degree of education,hospitalization cost,hospital day,combined with the disease type,ability of daily living(ADL),cognitive function,nutrition state,and the risk of fall/falling out of bed between frailty group and non-frailty group(P<0.05).The constituent ratios of coronary heart disease,chronic heart failure and cerebrovascular disease in frailty group were significantly higher than those in non-frailty group(all P<0.05).The levels of red blood cell count,lymphocyte percentage,and albumin were significantly lower,and the levels of neutrophil count,the percentage of neutrophils,uric acid,creatinine,and Cystatin C were significantly higher and the left atrial diameter was Significantly larger in frailty group than that in non-frailty group(all P<0.05).Binary Logistic regression analysis showed that ADL impairment(OR=7.800,95%CI2.205-27.590),malnutrition(OR=3.935,95%CI1.636-9.461),high level of Cystatin C(OR=5.937,95%CI 1.541-22.876),large left atrium inner diameter(OR=1.069,95%CI 1.001-1.141),coronary heart disease(OR=2.299,95%CI 1.087-4.864)were risk factors,but the high albumin level(OR=0.864,95%CI 0.779-0.958)was a protective factor for frailty hospitalized elderly patients.Conclusions The incidence of frailty in hospitalized elderly patients is high.It is recommended that medical staff

关 键 词：衰弱 住院老年病人 影响因素 

分 类 号：R592[医药卫生—老年医学]