Department of Nursing, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Department of Endocrinae. Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
BMC Geriatr. 2020 Mar 12;20(1):100. doi: 10.1186/s12877-020-1496-1.
To date, most previous studies of frailty among hospitalized elderly Chinese patients have been conducted based on small samples, which cannot represent the elderly patient population. The aim of this study was to identify the prevalence of and risk factors for frailty among elderly patients in China.
This cross-sectional study surveyed 9996 elderly patients from 6 tertiary-level hospitals in China. The prevalence of frailty among patients from selected wards was surveyed by trained investigators. A mixed-effects Poisson regression model was used to analyse the factors associated with frailty among elderly patients.
The mean age of all subjects was 72.47 ± 5.77 years. The prevalence rate of frailty in this study was 18.02%. After adjustments were made for the confounding effect of the clustering of hospital wards, a mixed-effects Poisson regression model showed that the associated factors of frailty included the following: age (OR: 1.016, 95% CI: 1.012-1.020), BMI < 18.5 (OR: 1.248, 95% CI: 1.171-1.330), female gender (OR: 1.058, 95% CI: 1.004-1.115), ethnic minority (OR: 1.152, 95% CI: 1.073-1.236), admission to hospital by the emergency department (OR: 1.104, 95% CI: 1.030-1.184), transit from another hospital (OR: 1.159, 95% CI: 1.049-1.279), former alcohol use (OR: 1.094, 95% CI: 1.022-1.171), fall history in the past 12 months (OR: 1.257, 95% CI: 1.194-1.323), vision dysfunction (OR: 1.144, 95% CI: 1.080-1.211), cognition impairment (OR: 1.182, 95% CI: 1.130-1.237), sleeping dysfunction (OR: 1.215, 95% CI: 1.215-1.318), urinary dysfunction (OR: 1.175, 95% CI: 1.104-1.251), and defecation dysfunction (OR: 1.286, 95% CI: 1.217-1.358). The results also showed some of the following protective effects: BMI > 28 (OR: 0.897, 95% CI: 0.856-0.940); higher education level, including middle school (OR: 0.915, 95% CI: 0.857, 0.977) and diploma and above (OR: 0.891, 95% CI: 0.821, 0.966); and current alcohol use (OR: 0.869, 95% CI: 0.815, 0.927).
We identified a relatively high prevalence of frailty among elderly patients, and there are several associated factors among the population derived from this investigation of a large-scale, multicentre, nationally representative Chinese elderly inpatient population.
Chinese Clinical Trial Registry, ChiCTR1800017682, registered 09 August 2018.
迄今为止,大多数针对中国住院老年患者衰弱的研究都是基于小样本进行的,这些研究无法代表老年患者人群。本研究旨在确定中国老年患者衰弱的患病率和危险因素。
这项横断面研究调查了来自中国 6 家三级医院的 9996 名老年患者。通过培训的调查人员调查了选定病房患者的衰弱患病率。使用混合效应泊松回归模型分析与老年患者衰弱相关的因素。
所有受试者的平均年龄为 72.47±5.77 岁。本研究的衰弱患病率为 18.02%。调整了医院病房聚类的混杂效应后,混合效应泊松回归模型显示,衰弱的相关因素包括:年龄(OR:1.016,95%CI:1.012-1.020)、BMI<18.5(OR:1.248,95%CI:1.171-1.330)、女性(OR:1.058,95%CI:1.004-1.115)、少数民族(OR:1.152,95%CI:1.073-1.236)、从急诊科入院(OR:1.104,95%CI:1.030-1.184)、从其他医院转入(OR:1.159,95%CI:1.049-1.279)、以前饮酒(OR:1.094,95%CI:1.022-1.171)、过去 12 个月有跌倒史(OR:1.257,95%CI:1.194-1.323)、视力障碍(OR:1.144,95%CI:1.080-1.211)、认知障碍(OR:1.182,95%CI:1.130-1.237)、睡眠障碍(OR:1.215,95%CI:1.215-1.318)、尿失禁(OR:1.175,95%CI:1.104-1.251)和排便障碍(OR:1.286,95%CI:1.217-1.358)。结果还显示出一些保护作用:BMI>28(OR:0.897,95%CI:0.856-0.940);更高的教育水平,包括中学(OR:0.915,95%CI:0.857,0.977)和大专及以上(OR:0.891,95%CI:0.821,0.966);以及目前饮酒(OR:0.869,95%CI:0.815,0.927)。
我们确定了中国老年患者衰弱的相对较高患病率,并且在从这项对中国大规模、多中心、具有代表性的老年住院患者人群进行的调查中,人群中存在几个相关因素。
中国临床试验注册中心,ChiCTR1800017682,2018 年 8 月 9 日注册。