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衰弱综合征与老年心力衰竭患者再住院

Frailty syndrome and rehospitalizations in elderly heart failure patients.

机构信息

Division of Nursing in Internal Medicine Procedures, Department of Clinical Nursing, Faculty of Health Sciences, Wroclaw Medical University, 5 Bartla Street, 51-618, Wroclaw, Poland.

Wrocław Department of Cardiology, T. Marciniak Lower Silesian Hospital, 2 Fieldorfa Street, 54-049, Wroclaw, Poland.

出版信息

Aging Clin Exp Res. 2018 Jun;30(6):617-623. doi: 10.1007/s40520-017-0824-6. Epub 2017 Aug 28.

Abstract

BACKGROUND

Heart failure (HF) patients with frailty syndrome (FS) are at higher risk of falling, decreased mobility, ability to perform the basic activities of daily living, frequent hospitalizations, and death.

AIMS

The purpose of this study was to evaluate the correlations between FS and hospital readmissions, and to assess which factors are associated with rehospitalizations.

METHODS

The study included 330 patients with a mean age of 72.1 ± 7.9 years, diagnosed with HF. Frailty was measured using the Polish version of the Tilburg Frailty Indicator (TFI). Demographic, sociodemographic, and clinical data, such as the New York Heart Association (NYHA) functional class, ejection fraction (EF), number of rehospitalizations, and the medications taken, were obtained.

RESULTS

Positive correlation was observed between the number of hospitalizations and FS. In the single-factor correlation analysis, treatment with diuretics, a higher NYHA class, and a lower left ventricular EF were predictors of a higher number of hospitalizations. Additionally, the physical and psychological components of the TFI, as well as the total TFI score, predisposed HF patients to more frequent hospitalizations.

DISCUSSION

It seems that a deterioration of functional capabilities and an increase in symptom severity naturally lead to increased hospitalization frequency in HF. In the own study, regression analysis indicates that high NYHA classes and TFI social component scores are significant predictors of the number of hospitalizations in the studied group.

CONCLUSIONS

FS is highly prevalent among elderly HF patients. Higher frailty levels in elderly patients are a determinant of more frequent rehospitalizations in HF.

摘要

背景

患有衰弱综合征(FS)的心力衰竭(HF)患者跌倒、活动能力下降、日常生活活动能力下降、频繁住院和死亡的风险更高。

目的

本研究旨在评估 FS 与住院再入院之间的相关性,并评估哪些因素与再入院相关。

方法

该研究纳入了 330 名平均年龄为 72.1±7.9 岁的 HF 患者。使用波兰版蒂尔堡衰弱指标(TFI)测量衰弱。收集人口统计学、社会人口学和临床数据,如纽约心脏协会(NYHA)功能分级、射血分数(EF)、再住院次数和服用的药物。

结果

住院次数与 FS 呈正相关。在单因素相关性分析中,利尿剂治疗、较高的 NYHA 分级和较低的左心室 EF 是住院次数增加的预测因素。此外,TFI 的身体和心理成分以及 TFI 总分使 HF 患者更容易频繁住院。

讨论

似乎功能能力的恶化和症状严重程度的增加自然导致 HF 住院频率增加。在本研究中,回归分析表明,较高的 NYHA 分级和 TFI 社会成分评分是研究组住院次数的显著预测因素。

结论

FS 在老年 HF 患者中很常见。老年患者的衰弱程度越高,HF 患者的再住院次数就越频繁。

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Frailty syndrome and rehospitalizations in elderly heart failure patients.衰弱综合征与老年心力衰竭患者再住院
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