埃德蒙顿衰弱量表在老年患者术前衰弱筛查中的应用  

Application of the Edmonton Frailty Scale in preoperative frailty screening in aged patients

作　　者：赵丽莉 陈兰[1] Zhao Lili;Chen Lan(Department of Nursing,North Campus,Shanghai General Hospital,Shanghai 200080,China)

机构地区：[1]上海市第一人民医院北部护理部,上海200080

出　　处：《中华现代护理杂志》2022年第20期2676-2680,共5页Chinese Journal of Modern Nursing

基　　金：上海市加强公共卫生体系建设三年行动计划项目(2020—2022年)(GWV-5)。

摘　　要：目的探讨埃德蒙顿衰弱量表(EFS)在老年手术患者术前衰弱筛查中的应用,并计算其最佳截止值。方法采用便利抽样法,选取2021年1—5月在上海市第一人民医院北部进行手术治疗的210例老年患者进行调查。采用自制一般资料调查表收集患者基线资料,使用EFS、衰弱表型对患者进行术前衰弱评估。采用受试者工作特征(ROC)曲线计算EFS最佳截止值,两量表之间的比较采用Kappa一致性检验和Pearson相关分析。结果EFS的ROC曲线下面积为0.858(95%CI:0.818~0.935),最佳截止值为8分,此时约登指数最大(0.655),灵敏度为79.3%,特异度为86.2%,阳性预测值为80.2%,阴性预测值为85.5%。EFS与衰弱表型之间呈高度一致性(Kappa值为0.656,P<0.01)和中度相关(r=0.715,P<0.01)。结论EFS对老年患者术前衰弱筛查的最佳截止值为8分,灵敏度、特异度较高,可作为术前衰弱筛查工具在临床中推广使用。Objective To explore the application of the Edmonton Frailty Scale(EFS)in preoperative frailty screening in aged surgical patients and calculate its optimal cutoff value.Methods Totally 210 aged patients undergoing surgery in the north campus,Shanghai General Hospital from January to May 2021 were selected by convenient sampling and investigated.A self-made general information questionnaire was used to collect the baseline data of these patients.EFS and frailty phenotype were used to evaluate their preoperative frailty.The receiver operating characteristic(ROC)curve was employed to calculate the optimal cutoff value for EFS,and the comparison between the two scales was performed by Kappa's consistency test and Pearson's correlation analysis.Results The area under the ROC curve of EFS was 0.858(95%CI:0.818-0.935),and the optimal cutoff value was 8 points.At this time,the Youden index was the largest(0.655),the sensitivity 79.3%,and the specificity 86.2%.The positive predictive value was 80.2%and the negative predictive value was 85.5%.There was high concordance(Kappa value 0.656,P<0.01)and moderate correlation(r=0.715,P<0.01)between EFS and frailty phenotype.Conclusions The optimal cutoff value of EFS for preoperative frailty screening in aged patients is 8 points,with high sensitivity and specificity.It can be used as a preoperative frailty screening tool in clinical practice.

关 键 词：老年人 衰弱 埃德蒙顿衰弱量表 术前筛查 

分 类 号：R592[医药卫生—老年医学]