Department of Nursing, Shanghai General Hospital, Shanghai Jiao Tong University School of Nursing, Shanghai, China.
School of Nursing, Xuzhou Medical University, Xuzhou, China.
J Adv Nurs. 2023 Sep;79(9):3522-3534. doi: 10.1111/jan.15676. Epub 2023 Apr 26.
To examine the prevalence and risk factors of pre-frailty and frailty in maintenance haemodialysis patients in China.
A cross-sectional study.
From January to July 2017, using the convenience sampling method, a total of 503 maintenance haemodialysis patients from six hospitals in Lianyungang, China, were recruited for this study. The participants' socio-demographic, lifestyle factors and health information were assessed using a general information questionnaire. Frailty was evaluated based on the Fried frailty phenotype. Multi-categorical logistic regression was performed to examine factors associated with pre-frailty and frailty in this population, including age, sex, living alone, employment, educational level, body mass index, per capita monthly household income, smoking status, exercise status, primary diagnosis, dialysis age, frequency of dialysis, vascular access, congestive heart failure, other cardiac diseases, cerebrovascular disease, peripheral blood diseases, pain, albumin level and haemoglobin level.
Among the 503 participants with an average age of 53.02 years (standard deviation 14.99), 178 had pre-frailty (35.3%) and were mostly young and middle-aged. The prevalence of pre-frailty among participants <60 years old was more than 40%. Regression analysis showed that lack of exercise, dialysis age ≤12 months, congestive heart failure and other cardiac diseases were positively associated with pre-frailty. Two hundred and eighteen participants were frail (43.3%), most of whom were aged ≥60. The prevalence of frailty in participants ≥60 was 71.4%. Regression analysis showed that advanced age, being female, obesity, low per capita monthly household income, lack of exercise, diabetes as the primary disease, dialysis age ≤12 months, congestive heart failure, other cardiac diseases, pain and low albumin level, were positively associated with frailty. In addition, more than half of the participants hardly exercised (64.6%), while lack of exercise was a risk factor for pre-frailty and frailty. A third of the participants had pain (33.4%), while pain was an independent risk factor for pre-frailty and frailty in these participants.
Pre-frailty and frailty are common in patients with maintenance haemodialysis. Most of the elderly maintenance haemodialysis patients are frail, and most of the young and middle-aged patients are pre-frail. Clinicians should actively screen the pre-frailty and frailty among patients with maintenance haemodialysis, especially those with dialysis age ≤12 months. Many factors affect pre-frailty and frailty in this population. Tailored intervention measures should be designed and implemented based on these factors, giving priority to exercise guidance and pain management for patients to help them prevent or reverse pre-frailty and frailty.
调查中国维持性血液透析患者衰弱前期和衰弱的患病率及其相关危险因素。
横断面研究。
2017 年 1 月至 7 月，采用便利抽样法，从中国连云港的 6 家医院招募了 503 名维持性血液透析患者。使用一般信息问卷评估参与者的社会人口统计学、生活方式因素和健康信息。基于 Fried 衰弱表型评估衰弱。采用多分类逻辑回归分析该人群衰弱前期和衰弱的相关因素，包括年龄、性别、独居、就业、教育程度、体重指数、人均月家庭收入、吸烟状况、运动状况、主要诊断、透析年龄、透析频率、血管通路、充血性心力衰竭、其他心脏疾病、脑血管疾病、外周血液疾病、疼痛、白蛋白水平和血红蛋白水平。
在 503 名平均年龄为 53.02 岁（标准差 14.99）的参与者中，178 名患有衰弱前期（35.3%），他们大多为中青年。60 岁以下参与者衰弱前期的患病率超过 40%。回归分析显示，缺乏运动、透析年龄≤12 个月、充血性心力衰竭和其他心脏疾病与衰弱前期呈正相关。218 名参与者衰弱（43.3%），他们大多≥60 岁。≥60 岁参与者衰弱的患病率为 71.4%。回归分析显示，高龄、女性、肥胖、人均月家庭收入低、缺乏运动、糖尿病作为主要疾病、透析年龄≤12 个月、充血性心力衰竭、其他心脏疾病、疼痛和低白蛋白水平与衰弱呈正相关。此外，超过一半的参与者几乎不运动（64.6%），而缺乏运动是衰弱前期和衰弱的危险因素。三分之一的参与者有疼痛（33.4%），而疼痛是这些参与者衰弱前期和衰弱的独立危险因素。
衰弱前期和衰弱在维持性血液透析患者中很常见。大多数老年维持性血液透析患者衰弱，而大多数中青年患者衰弱前期。临床医生应积极筛查维持性血液透析患者的衰弱前期和衰弱，特别是透析年龄≤12 个月的患者。许多因素影响该人群的衰弱前期和衰弱。应根据这些因素设计和实施针对性的干预措施，优先为患者提供运动指导和疼痛管理，帮助他们预防或逆转衰弱前期和衰弱。
