The association between frailty of older stroke patients during hospitalization and one-year all-cause mortality:A multicenter survey in China  

脑卒中住院老年患者衰弱状态与1年后全因死亡的关联研究

作　　者：Xiao-Ming Zhang Jing Jiao Tao Xu Xin-Juan Wu 张小明;焦静;徐涛;吴欣娟(Department of Nursing,Chinese Academy of Medical Sciences,Peking Union Medical College,Peking Union Medical College Hospital,China;Department of Epidemiology and Statistics,Institute of Basic Medical Sciences,Chinese Academy of Medical Sciences&School of Basic Medicine,Peking Union Medical College,China)

机构地区：[1]Department of Nursing,Chinese Academy of Medical Sciences,Peking Union Medical College,Peking Union Medical College Hospital,China [2]Department of Epidemiology and Statistics,Institute of Basic Medical Sciences,Chinese Academy of Medical Sciences&School of Basic Medicine,Peking Union Medical College,China

出　　处：《International Journal of Nursing Sciences》2022年第2期162-168,I0004,共8页国际护理科学（英文）

基　　金：Fundamental Research Funds for Central Universities of Peking Union Medical College(No.3332020007).

摘　　要：Objective:Frailty is a common geriatric syndrome defined as multiple deficits,impairing the capacity to figure out insult.Previous studies have reported a significant association between frailty and mortality in stroke patients.This study aimed to explore the association between frailty and mortality among older Chinese stroke patients.Methods:This study was a secondary analysis of a multicenter prospective cohort study conducted in older Chinese inpatients from October 2018 to February 2020,and patients with a primary diagnosis of stroke including hemorrhage and ischemia,were included in our study.Frailty of older inpatients with stroke from six hospitals was measured by the FRAIL scale,and a one-year follow-up was performed by well-trained nurses of these hospitals via telephone.Multivariable logistic regression was used to detect the association between frailty and one-year mortality.Results:A total of 530 stroke patients with an average age of 72.94(SD¼5.79)years were included in the present study.There were 37(7.0%)hemorrhagic strokes and 493(93.0%)ischemic strokes,with 228(43.0%)females in this population.The prevalence of frailty was 22.5%.In the logistic regression model with adjustment for age,sex,instrumental activities of daily living(IADL),basic activities of daily living(ADL),education,history of falls,BMI,smoking,alcohol consumption,low handgrip strength,type of stroke and polypharmacy,stroke patients with frailty had an increased risk of one-year mortality compared to those without frailty(OR¼3.38,95%CI:1.22e9.37,P¼0.019).Conclusion:Our study indicated that frailty was an independent risk factor for one-year all-cause mor-tality among older stroke patients in China.Frailty may be an essential factor for clinicians to consider before making a comprehensive treatment,and corresponding mixed interventions,including exercise training and nutritional programs,need to be conducted among older stroke patients.目的衰弱是常见的老年综合征,表现为多系统功能的缺失,导致老年人处理外界伤害的能力降低。本研究旨在探讨中国老年脑卒中患者住院期间衰弱状态与脑卒中1年后死亡的关联。方法本研究为对一项中国人群前瞻性队列研究项目进行的二次数据分析,项目完成时间为2018年10月至2020年2月。本研究中纳入的病例包括缺血性脑卒中及出血性脑卒中患者。采用衰弱量表评估患者住院期间衰弱状态;由经过规范培训的病房护士通过电话随访患者1年后生存结果。采用多元Logistic回归分析确定衰弱与脑卒中1年后死亡的关联。结果共530例脑卒中患者纳入本项研究,平均年龄为72.94岁(SD=5.79),女性患者228例(43.02%);37例出血性脑卒中,493例缺血性脑卒中;衰弱发生率为22.4%。在调整年龄、性别、教育、基础日常生活活动、工具性日常生活活动、BMI、跌倒史、吸烟及饮酒史、低握力和多重用药后,脑卒中患者合并衰弱时,其1年后全因死亡风险高于没有合并衰弱的脑卒中患者(OR=3.38,95%CI:1.22~9.37,P=0.019)。结论衰弱是老年脑卒中患者1年后全因死亡的独立危险因素,应作为对脑卒中患者进行综合评估的重要问题。应对脑卒中患者实施相应的干预策略,如运动训练及营养干预,以改善老年患者衰弱状况。

关 键 词：Activities of daily living Aged China FRAILTY STROKE 

分 类 号：R743.3[医药卫生—神经病学与精神病学]