评估多学科伤口护理中心老年患者的虚弱程度：一项队列研究。
Assessment of frailty in elderly patients attending a multidisciplinary wound care centre: a cohort study.
机构信息
Tissue Repair and Regeneration Laboratory (TR2Lab), Centre for Health and Social Care Research (CESS), University of Vic - Central University of Catalonia (UVIC-UCC), Fundació Hospital Universitari de la Santa Creu de Vic, and Hospital Universitari de Vic, 08500, Vic, Barcelona, Spain.
Hospital Universitari de la Santa Creu de Vic, 08500, Vic, Barcelona, Spain.
出版信息
BMC Geriatr. 2021 Dec 18;21(1):727. doi: 10.1186/s12877-021-02676-y.
BACKGROUND
The incidence of frailty and non-healing wounds increases with patients' age. Knowledge of the relationship between frailty and wound healing progress is greatly lacking.
METHODS
The aim of this study is to characterize the degree of frailty in elderly patients attending a multidisciplinary wound care centres (MWCC). Additionally, we seek to assess the impact of frailty on the wound healing rate and wound healing time. An open cohort study was conducted on 51 consecutive patients aged > 70 years treated for wounds at an MWCC of an intermediate care hospital. The frailty score was determined according to the Frail-VIG index. Data were collected through patient questionnaires at the beginning of the study, and at 6 months or upon wound healing. Wounds were followed up every 2 weeks. To analyse the relationship between two variables was used the Chi-square test and Student's or the ANOVA model. The t-test for paired data was used to analyse the evolution of the frailty index during follow-up.
RESULTS
A total of 51 consecutive patients were included (aged 81.1 ± 6.1 years). Frailty prevalence was 74.5% according to the Frail-VIG index (47.1% mildly frail, 19.6% moderately frail, and 7.8% severely frail). Wounds healed in 69.6% of cases at 6 months. The frailty index (FI) was higher in patients with non-healing wounds in comparison with patients with healing wounds (IF 0.31 ± 0.15 vs IF 0.24 ± 0.11, p = 0.043). A strong correlation between FI and wound healing results was observed in patients with non-venous ulcers (FI 0.37 ± 0.13 vs FI 0.27 ± 0.10, p = 0.015). However, no correlation was observed in patients with venous ulcers (FI 0.17 ± 0.09 vs FI 0.19 ± 0.09, p = 0.637). Wound healing rate is statically significantly higher in non-frail patients (8.9% wound reduction/day, P25-P75 3.34-18.3%/day;AQ6 p = 0.044) in comparison with frail patients (3.26% wound reduction/day, P25-P75 0.8-8.8%/day).
CONCLUSION
Frailty is prevalent in elderly patients treated at an MWCC. Frailty degree is correlated with wound healing results and wound healing time.
背景
虚弱和非愈合伤口的发生率随着患者年龄的增长而增加。人们对虚弱和伤口愈合进展之间的关系知之甚少。
方法
本研究旨在描述在多学科伤口护理中心（MWCC）就诊的老年患者的虚弱程度。此外，我们还评估了虚弱对伤口愈合率和伤口愈合时间的影响。对一家中级护理医院的 MWCC 治疗的 51 例连续＞70 岁的患者进行了一项开放队列研究。根据脆弱性-视觉模拟量表（Frailty-VIG）确定虚弱评分。在研究开始时、6 个月或伤口愈合时通过患者问卷调查收集数据。每 2 周对伤口进行随访。使用卡方检验和学生 t 检验或方差分析模型分析两个变量之间的关系。使用配对数据的 t 检验分析随访过程中虚弱指数的变化。
结果
共纳入 51 例连续患者（年龄 81.1±6.1 岁）。根据脆弱性-视觉模拟量表（Frailty-VIG），虚弱的患病率为 74.5%（轻度脆弱 47.1%，中度脆弱 19.6%，重度脆弱 7.8%）。6 个月时，69.6%的患者伤口愈合。与愈合伤口的患者相比，未愈合伤口的患者的虚弱指数（FI）更高（FI 0.31±0.15 与 FI 0.24±0.11，p=0.043）。在非静脉性溃疡患者中，FI 与伤口愈合结果之间存在很强的相关性（FI 0.37±0.13 与 FI 0.27±0.10，p=0.015）。然而，在静脉性溃疡患者中未观察到相关性（FI 0.17±0.09 与 FI 0.19±0.09，p=0.637）。非脆弱患者的伤口愈合率明显更高（每天减少 8.9%的伤口，P25-P75 3.34-18.3%/天；AQ6 p=0.044）与脆弱患者相比（每天减少 3.26%的伤口，P25-P75 0.8-8.8%/天）。
结论
MWCC 治疗的老年患者中虚弱较为普遍。虚弱程度与伤口愈合结果和伤口愈合时间相关。
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