老年慢性病患者疲乏发生风险列线图模型的构建  

Construction of a Nomogram Model of Fatigue Risk in Elderly Patients with Chronic Diseases

作　　者：陈梦奇 迟晨汝 杨丹 周志庆[2] 刘欢[2] 王晓晔[2] CHEN Mengqi;CHI Chenru;YANG Dan;ZHOU Zhiqing;LIU Huan;WANG Xiaoye(Graduate College of Southern Anhui Medical College)

机构地区：[1]皖南医学院研究生学院,安徽芜湖241002 [2]皖南医学院第一附属弋矶山医院

出　　处：《长治医学院学报》2024年第3期184-188,193,共6页Journal of Changzhi Medical College

基　　金：2022年安徽省新时代育人质量工程项目(2022jyjxggyj338);2020年芜湖市科技计划项目(2020rkx4-5);2021年皖南医学院中青年科研项目(WKS2021F01)。

摘　　要：目的:探讨老年慢性病患者疲乏的现状及影响因素,并构建其风险预测模型。方法:采用便利抽样法选择2023年2—8月芜湖市某三级甲等医院320例老年慢性病患者作为研究对象,选用一般资料调查表、疲劳量表、Frail衰弱量表及肌少症量表对320例老年慢性病患者进行问卷调查,将单因素分析有意义的变量纳入二元Logistic回归,筛选出影响疲乏的危险因素,使用ROC曲线、Homster-Lemeshow拟合度检验、校准曲线、DCA曲线分别对模型进行评价。结果:178例老年慢性病患者发生疲乏,疲乏发生率为55.63%;二元Logistic回归分析显示,高龄(OR=2.135)、多重患病(OR=2.111)、多重用药(OR=2.952)、衰弱(OR=7.565)、肌少症(OR=3.284)均是老年慢性病患者疲乏的危险因素;基于以上5项独立危险因素建立老年慢性病患者疲乏发生风险的列线图模型,经ROC曲线和H-L验证该模型具有较好的区分度和准确度,临床决策曲线均在有效范围内。结论:老年慢性病患者疲乏发生率较高,受到年龄、多重患病、多重用药、衰弱、肌少症的影响;基于以上危险因素构建的列线图模型具有较好的预测作用,可为临床医务人员筛选疲乏高风险人群及提前采取干预措施提供科学依据。Objective:To explore the current situation and influencing factors of fatigue in elderly patients with chronic diseases,and to construct a risk prediction model.Methods:Using convenience sampling method,320 elderly patients with chronic diseases from a tertiary Grade-A hospital in Wuhu city from February 2023 to August 2023 were selected as research subjects.A general information questionnaire,fatigue scale,frailty scale,and sarcopenia scale were used to conduct a questionnaire survey on the 320 elderly patients with chronic diseases.Based on whether elderly patients with chronic diseases experienced fatigue,they were divided into a fatigue group(n=178)and a non-fatigue group(n=142).The meaningful variables from univariate analysis were included in the binary logistic regression for the risk factors affecting fatigue,and the models were evaluated using ROC curve,Homster-Lemeshow fit test,calibration curve and DCA curve.Results:178 elderly chronic disease patients experienced fatigue,and the incidence of fatigue was 55.63%.Binary logistic regression analysis showed that advanced age(OR=2.135),multiple diseases(OR=2.111),multiple medication(OR=2.952),frailty(OR=7.565),sarcopenia(OR=3.284)were all risk factors for fatigue in elderly patients with chronic diseases.Based on the above five independent risk factors,the nomogram model of fatigue risk in elderly chronic patients was established.The ROC curve and H-L verified that the model had good differentiation and accuracy.The clinical decision curve was within the effective range,indicating that the model had good clinical practicability.Conclusion:Elderly patients with chronic diseases fatigue incidence is higher,which is affected by age,multiple disease,multiple medication,frailty,and sarcopenia.The nomogram model based on the above risk factors has good prediction for clinical medical staff screening fatigue high risk groups,which providing scientific basis for intervention measures in advance.

关 键 词：老年 疲乏 慢性病 影响因素 预测模型 

分 类 号：R194[医药卫生—卫生事业管理]