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中国人民解放军总医院
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中国人民解放军总医院老年心血管病研究所
中国科技出版传媒股份有限公司
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中华老年多器官疾病杂志编辑委员会
100853, 北京市复兴路28号
电话:010-66936756
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E-mail: zhlndqg@mode301.cn
创刊人 王士雯
总编辑 范利
副总编辑 陈韵岱
执行主编 叶大训
编辑部主任 王雪萍
ISSN 1671-5403
CN 11-4786
创刊时间 2002年
出版周期 月刊
邮发代号 82-408
友情链接
周莉华,王凌霄,杨永学,管丽娟,邓明洪,沈静.住院共病老年人衰弱状态分布及其影响因素[J].中华老年多器官疾病杂志,2019,18(1):6~11
住院共病老年人衰弱状态分布及其影响因素
Frail status and influencing factors in elderly inpatients with comorbidity
投稿时间:2018-09-10  修订日期:2018-10-09
DOI:10.11915/j.issn.1671-5403.2019.01.002
中文关键词:  老年人;住院病人;共病;衰弱
英文关键词:aged; inpatients; comorbidity; frailty
基金项目:四川省卫生与计划生育委员会科研课题(150021) 王凌霄,为共同第一作者
作者单位E-mail
周莉华 成都市第五人民医院老年科,成都 611130;成都市第五人民医院中法老年疾病研究所,成都 611130  
王凌霄 成都市第五人民医院老年科,成都 611130;成都市第五人民医院中法老年疾病研究所,成都 611130  
杨永学 成都市第五人民医院老年科,成都 611130;成都市第五人民医院中法老年疾病研究所,成都 611130  
管丽娟 成都市第五人民医院老年科,成都 611130;成都市第五人民医院中法老年疾病研究所,成都 611130  
邓明洪 成都市第五人民医院老年科,成都 611130;成都市第五人民医院中法老年疾病研究所,成都 611130  
沈静 成都市第五人民医院老年科,成都 611130;成都市第五人民医院中法老年疾病研究所,成都 611130 drshenjing@163.com 
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中文摘要:
      目的 明确住院共病老年人衰弱状态分布特点,进一步探讨其影响因素。方法 横断面调查选取2015年11月至2017年7月成都市第五人民医院老年科收治的≥60岁住院共病患者440例。根据衰弱状态将患者分为衰弱组150例及非衰弱组290例,比较2组患者一般人口学资料、共病、衰弱状态及老年综合征情况。采用SPSS 23.0进行统计分析。根据数据类型,组间比较采用独立样本t检验、Mann-Whitney U检验或χ2检验。采用Mantel-Haenszel χ2检验分析衰弱分布趋势。危险因素分析采用向后逐步法二元 logistic 回归。结果 440例患者总体存在5(4,7)种慢性疾病,Charlson合并症指数(CCI)为(5.59±1.82)分。入选患者衰弱患病率为34.1%(150/440), 衰弱前期占60.0%(264/440)。趋势性检验结果显示,随年龄和CCI评分升高,衰弱患病率显著增加,差异有统计学意义(P<0.05);衰弱五要素中,体质量下降发生率随年龄和CCI评分增加而增加,握力下降和疲乏发生率随年龄增加而增加,差异亦有统计学意义(P<0.05)。与非衰弱患者比较,衰弱组患者年龄增大,学历较低,合并慢性心力衰竭、慢性阻塞性肺疾病、抑郁、认知功能障碍、尿失禁、高跌倒风险、功能依赖的比例显著升高,但多重用药比例显著降低,差异有统计学意义(P<0.05)。经校正混杂因素后,二元logistic回归分析表明,抑郁(OR=2.178,95%CI 1.252~3.790)和功能依赖(OR=1.942,95%CI 1.029~3.668)是衰弱的独立危险因素。结论 住院共病老人中普遍存在衰弱,且衰弱的患病率与年龄和共病严重程度呈趋势性增加,抑郁和功能依赖与衰弱状态密切相关。
英文摘要:
      Objective To clarify the distribution characteristics of frail status in elderly inpatients with comorbidity, and to further explore its influencing factors. Methods A cross-sectional survey was conducted among 440 inpatients with comorbidities over 60 years old in our department from November 2015 to July 2017. According to their status of frailty, they were divided into frailty group (n=150) and non-frailty group (n=290). The general demographic data, comorbidities, frailty status and senile syndrome were compared between the 2 groups. SPSS statistics 23.0 was used for statistical analysis. Independent sample t test, Mann-Whitney U test or Chi-square test was used to compare the difference between 2 groups. Mantel-Haenszel Chi-square test was employed to analyze the trend of frailty distribution. Risk factors were analyzed by backward stepwise binary logistic regression. Results Among the 440 elderly patients, they suffered from 5(4,7) kinds of chronic diseases on average, and the mean score of Charlson comorbidity index (CCI) was (5.59±1.82). The prevalence of frailty was 34.1%(150/440), and that of pre-frailty status was 60.0%(264/440). Trend test results showed that with older age and increased CCI score, the prevalence of frailty was increased significantly (P<0.05). Among the 5 factors of frailty, the incidence of weight loss was increased with older age and increased CCI score, while the incidences of grip decrease and fatigue were increased with older age (P<0.05). Compared with non-frailty group, the frailty group were older, lower educational level, and higher fall risk, and were more prone to having chronic heart failure, chronic obstructive pulmonary disease (COPD), depression, cognitive impairment, urinary incontinence, and functional dependence, but they had significantly lower proportion of polypharmacy (all P<0.05). After adjustment for confounding factors, binary logistic regression analysis showed that depression (OR=2.178, 95%CI 1.252-3.790) and functional dependence (OR=1.942,5%CI 1.029-3.668) were independentrisk factors for frailty. Conclusion Frailty is common in the elderly inpatients with comorbidities, and the prevalence of frailty tends to increase with oler age and severer comorbidities. Depression and functional dependence are closely related to the status of frailty.
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