老年结直肠癌化疗病人衰弱前期风险预测模型的构建  

The construction of risk prediction model of pre-frailty in elderly patients with colorectal cancer undergoing chemotherapy

作　　者：卢进红 陈海韵 钟雯雯 谭玉蕾 卓莉 袁雅琴 LU Jinhong;CHEN Haiyun;ZHONG Wenwen;TAN Yulei;ZHUO Li;YUAN Yaqin(Zhujiang Hospital of Southern Medical University,Guangdong 510250 China)

机构地区：[1]南方医科大学珠江医院,广东510250

出　　处：《护理研究》2025年第6期910-918,共9页Chinese Nursing Research

摘　　要：目的:调查老年结直肠癌化疗病人衰弱前期现状,分析其影响因素并构建风险预测模型。方法:采用便利抽样法,选取2023年9月1日—2024年2月18日在广州市某三级甲等医院住院的290例老年结直肠癌化疗病人作为研究对象,采用一般资料调查表、Fried衰弱表型、医院焦虑抑郁量表、营养风险筛查2002、Barthel指数、安德森症状评估量表、社会支持评定量表、睡眠状况自评量表、画钟试验对病人进行调查评估,采用Logistic回归分析探讨影响因素,采用RStudio(4.1.1)构建列线图风险预测模型,采用Hosmer-Lemeshow拟合优度检验和受试者工作特征曲线分析模型的拟合优度及预测效能。结果:290例病人中,191例病人处于衰弱前期,占65.9%。Logistic回归分析结果显示,年龄、跌倒史、造口、血红蛋白浓度、白细胞计数、营养不良风险、抑郁状况、神经躯体症状是老年结直肠癌化疗病人的衰弱前期影响因素。Hosmer-Lemeshow拟合优度检验结果显示,χ^(2)=6.896,P=0.548;受试者工作特征曲线下面积为0.867[95%CI(0.825,0.909)],临界值为0.633时Youden指数最大,为0.568,敏感度为0.780,特异度为0.788。结论:处于衰弱前期的老年结直肠癌化疗病人比例较高,年龄、跌倒史、造口、血红蛋白浓度、白细胞计数、营养不良风险、抑郁状况、神经躯体症状对老年结直肠癌化疗病人的衰弱前期有影响,基于影响因素构建的风险预测模型具有一定的预测能力和鉴别能力。Objective:To investigate the statues quo of pre-frailty in elderly patients with colorectal cancer undergoing chemotherapy,analyze its influencing factors and construct a risk prediction model.Methods:A total of 290 elderly patients with colorectal cancer undergoing chemotherapy who were hospitalized in a tertiary hospital in Guangzhou were selected as subjects by convenience sampling from September 1,2023 to February 18,2024.General information questionnaire,Frailty Phenotype,The Hospital Anxiety and Depression Scale,Nutritional Risk Screening 2002,Barthel Index,The M.D.Anderson Symptom Inventory,Social Support Scale,Seff-Rating Scale of Sleep,and Clock Drawing Test were used to investigate and evaluate patients.Logistic regression analysis was used to explore the influencing factors,RStudio(version 4.1.1)was used to construct the Nomogram risk prediction model,and the Hosmer-Lemeshow goodness-of-fit test and receiver operator characteristic curve were used to analysis the goodness-of-fit and prediction performance of the model.Results:Among the 290 patients,191 patients were in the pre-frailty,accounting for 65.9%.Logistic regression analysis showed that age,history of falls,stoma,hemoglobin,white blood cell count,malnutritional risk,depression status and neuropsychiatric symptoms were the influencing factors of pre-frailty in elderly patients with colorectal cancer undergoing chemotherapy.The results of Hosmer-Lemeshow goodness-of-fit test showed thatχ^(2)=6.896,P=0.548,area under the curve of receiver operator characteristic was 0.867(95%CI 0.825-0.909).The Youden index was the highest(0.568),the sensitivity was 0.780,and the specificity was 0.788 when the critical value was 0.633.Conclusions:The proportion of elderly patients with colorectal cancer undergoing chemotherapy in the stage of pre-frailty is high,and age,history of falls,stoma,hemoglobin,white blood cell count,malnutritional risk,depression status and neurosomatic symptoms are significant predictors of pre-frailty in elderly patients with colorec

关 键 词：老年人 结直肠癌 化疗 衰弱前期 影响因素 风险预测 列线图 护理 

分 类 号：R73[医药卫生—肿瘤]