衰弱对老年心房颤动住院患者预后的影响  

Effect of frailty on the prognosis of elderly patients with atrial fibrillation

作　　者：崔玲玲 王颖 孙梦妍 李菲 严蕊 郑裴裴 姚思敏[1] 李莹莹[1] 王华[1] Cui Lingling;Wang Ying;Sun Mengyan;Li Fei;Yan Rui;Zheng Peipei;Yao Simin;Li Yingying;Wang Hua(Department of Cardiology,Beijing Hospital,National Center of Gerontology/Institute of Geriatric Medicine,Chinese Academy of Medical Sciences,Beijing 100730,China)

机构地区：[1]北京医院心内科,国家老年医学中心,中国医学科学院老年医学研究院,100730

出　　处：《中国心血管杂志》2022年第1期23-27,共5页Chinese Journal of Cardiovascular Medicine

基　　金：北京市科技重大专项(D181100000218003)。

摘　　要：目的评估因心房颤动住院的老年患者中衰弱的发生情况,并探讨衰弱对预后的影响。方法前瞻性队列研究,连续纳入2018年9月至2019年2月在北京医院心内科因心房颤动住院的153例老年患者。使用Frail衰弱评估量表评估患者的衰弱情况,并分为衰弱组(38例)和非衰弱组(115例)。使用一般资料调查表调查患者的一般情况,并建立电子数据库。分别在患者出院时、入组后3个月和6个月进行随访,记录复合终点事件,包括全因死亡、再入院和跌倒。应用Kaplan-Meier生存分析和Cox风险比例回归模型探究患者衰弱与复合终点事件的关系。结果153例老年心房颤动患者中,衰弱发生率为24.8%(38例),复合终点事件发生率为35.3%(54例)。Kaplan-Meier生存分析显示,随着时间的变化,衰弱组和非衰弱组的复合终点事件发生率差异有统计学意义(Log-rank检验,χ^(2)=3.877,P<0.05)。调整年龄、跌倒史、合并症等协变量后,Cox风险比例回归结果显示衰弱是复合终点事件的独立危险因素(HR=2.969,95%CI:1.238~7.120,P<0.05)。结论衰弱在老年心房颤动住院患者中的发生率较高,且为不良预后的独立预测因素。Objective To evaluate the incidence of frailty in elderly patients with atrial fibrillation and to explore the impact of frailty on prognosis.Methods This study was a prospective cohort study of elderly patients with atrial fibrillation admitted to the Department of Cardiology,Beijing Hospital from September 2018 to February 2019.Frailty was assessed using the Frail Scale,general condition was investigated using the General Information Questionnaire,and an electronic database was established.Patients were followed up at discharge,3 months and 6 months after enrolment,and all-cause deaths,readmissions,and falls were recorded to construct a compound end point.Kaplan-Merier survival analysis and Cox proportional hazard regression model were used to explore the relationship between frailty and compound end points.Results The incidence of frailty and incidence of compound end points were 24.8%(38 cases)and 35.3%(54 cases).Kaplan-Merier survival analysis showed a statistically significant difference in the incidence of compound end points between the frailty group and the non-frailty group over time(Log-rank χ^(2)=3.877,P<0.05).After controlling for covariates,Cox proportional risk regression showed that frailty was an independent risk factor for the compound end points(HR=2.969,95%CI:1.238-7.120,P<0.05).Conclusions Frailty has a high incidence in elderly inpatients with atrial fibrillation and is an independent predictor of poor prognosis.

关 键 词：衰弱 老年人 心房颤动 预后 

分 类 号：R541.75[医药卫生—心血管疾病]