Maloberti Alessandro, Fribbi Francesco, Motto Elena, Vallerio Paola, Occhi Lucia, Palazzini Matteo, Peretti Alessio, Ferraro Giovanni, Agrati Antonio, Colombo Fabrizio, Giannattasio Cristina
School of Medicine and Surgery, Milano-Bicocca University, Milan, Italy,
Cardiology 4, ASST GOM Niguarda Ca Granda Hospital, Milan, Italy,
Gerontology. 2021;67(6):674-680. doi: 10.1159/000514450. Epub 2021 Mar 23.
Atherosclerosis causes a chronic reduction of vascularization with consequent impairment of the performance of organs, like the brain or muscles, which determines the functional and cognitive decline of the elderly and their ability to respond to acute stressful condition. Therefore, our aim was to evaluate if ankle brachial index (ABI) could effectively be a determinant of in-hospital functional status and complications in elderly hospitalized patients.
This is a monocentric cross-sectional study of 189 patients aged 65 years or older. The study was undertaken at the Internal Medicine ward of Niguarda Hospital in Milan. ABI (BOSO ABY-System 100) and in-hospital status (activities of daily living, ADL and instrumental activities of daily living, IADL) were collected on the second day of hospitalization. Complications (falls and delirium episodes) were also recorded during the whole hospitalization period.
The average age of patients was 79.3 ± 6.9 years. Among outcomes, only ADL (r = 0.192, p = 0.007) and IADL score (r = 0.200, p = 0.005) showed significant correlation with ABI. Moreover, during the subsequent logistic regression, ABI remained among the statistically significant determinants of both scores (β = 0.231, p = 0.013 and β = 0.314, p = 0.001, respectively).
The main result of our study is the finding of ABI as a significant determinant of acute in-hospital functional impairment (evaluated as ADL and IADL scores). The continuous exposure of the brain and muscles to the reduced perfusions induced by vascular atherosclerosis, probably determined the reduced ability to respond to stressful conditions.
动脉粥样硬化导致血管化长期减少，进而损害器官（如大脑或肌肉）的功能，这决定了老年人的功能和认知能力下降以及他们应对急性应激状况的能力。因此，我们的目的是评估踝臂指数（ABI）是否能有效决定老年住院患者的院内功能状态和并发症。
这是一项对189名65岁及以上患者进行的单中心横断面研究。该研究在米兰尼瓜尔达医院的内科病房进行。在住院第二天收集ABI（BOSO ABY - System 100）和院内状态（日常生活活动能力，ADL和工具性日常生活活动能力，IADL）。在整个住院期间还记录了并发症（跌倒和谵妄发作）。
患者的平均年龄为79.3±6.9岁。在各项结果中，只有ADL（r = 0.192，p = 0.007）和IADL评分（r = 0.200，p = 0.005）与ABI显示出显著相关性。此外，在随后的逻辑回归分析中，ABI仍然是这两个评分的统计学显著决定因素（β分别为0.231，p = 0.013和β为0.314，p = 0.001）。
我们研究的主要结果是发现ABI是急性院内功能损害（以ADL和IADL评分评估）的重要决定因素。大脑和肌肉持续暴露于血管动脉粥样硬化引起的灌注减少，可能决定了应对应激状况的能力下降。
