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老年多病患者衰弱状况及不良结局研究。

Research on the frailty status and adverse outcomes of elderly patients with multimorbidity.

机构信息

West China School of Nursing/ West China Hospital Endocrinology and Metabolism Department, Sichuan University, Chengdu, 610041, People's Republic of China.

West China Hospital Endocrinology and Metabolism Department/ West China School of Nursing, Sichuan University, Chengdu, 610041, People's Republic of China.

出版信息

BMC Geriatr. 2022 Jul 6;22(1):560. doi: 10.1186/s12877-022-03194-1.

Abstract

BACKGROUND

As patients age, the frailty of those with multimorbidity increases, often resulting in adverse health outcomes. The current study investigated the frailty status and the factors which influence it in elderly patients with multimorbidity in Chinese hospitals. The relationship between the frailty of patients with multimorbidity and adverse outcomes was explored.

METHODS

The current prospective cohort study investigated inpatients in the internal medicine department of 5 tertiary hospitals in Sichuan Province, China. A total of 3836 elderly patients with multimorbidity were enrolled. Frailty was assessed using the FRAIL scale and adverse outcome events occurring during hospitalization were tracked. Descriptive statistics and logistic regressions were used for data analysis.

RESULTS

The prevalence of frailty was 27.2% and of pre-frailty, 58.9%. Logistic regression analysis showed that increasing age, low BMI, low education level, lack of exercise, multiple types of medications and multiple numbers of chronic diseases were the main risk factors for frailty in elderly patients with multimorbidity (OR values: 1.020, 1.469, 2.350, 2.836, 1.156 and 1.308, respectively). The incidence of adverse outcomes was 13.9% among the cohort with the most common being deep vein thrombosis (42.4%), followed by pressure injury (38.8%). Regression analysis showed a significant correlation of frailty with adverse outcome (OR: 1.496; p < 0.01).

CONCLUSIONS

The prevalence of frailty and pre-frailty in hospitalized elderly patients with multimorbidity was high. Increasing age, low BMI, low education level, lack of exercise, multiple types of medications and multiple numbers of chronic diseases were factors which influenced frailty and frailty was an important factor in the occurrence of adverse outcomes. The most common adverse outcome of elderly multimorbidity patients during hospitalization was deep vein thrombosis.

摘要

背景

随着患者年龄的增长,患有多种疾病的患者的虚弱程度会增加,这往往会导致不良的健康结局。本研究调查了中国医院中患有多种疾病的老年患者的虚弱状况及其影响因素。探讨了患有多种疾病的患者的虚弱状况与不良结局之间的关系。

方法

本前瞻性队列研究调查了中国四川省 5 家三级医院内科的住院患者。共纳入 3836 名患有多种疾病的老年患者。使用 FRAIL 量表评估虚弱状况,并跟踪住院期间发生的不良结局事件。采用描述性统计和逻辑回归进行数据分析。

结果

虚弱的患病率为 27.2%,衰弱前期的患病率为 58.9%。逻辑回归分析显示,年龄增长、低 BMI、低教育水平、缺乏运动、多种药物和多种慢性疾病是老年多病患者发生虚弱的主要危险因素(OR 值分别为 1.020、1.469、2.350、2.836、1.156 和 1.308)。该队列的不良结局发生率为 13.9%,最常见的是深静脉血栓形成(42.4%),其次是压疮(38.8%)。回归分析显示,虚弱与不良结局显著相关(OR:1.496;p<0.01)。

结论

住院老年多病患者的虚弱和衰弱前期患病率较高。年龄增长、低 BMI、低教育水平、缺乏运动、多种药物和多种慢性疾病是影响虚弱的因素,虚弱是不良结局发生的重要因素。老年多病患者住院期间最常见的不良结局是深静脉血栓形成。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e227/9258158/991c36e37a46/12877_2022_3194_Fig1_HTML.jpg

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