Department of Nursing, Shanghai General Hospital, Shanghai Jiao Tong University School of Nursing, Shanghai, China.
Department of Nursing, Taihe County People's Hospital, Fuyang, Anhui, China.
Br J Hosp Med (Lond). 2024 Sep 30;85(9):1-21. doi: 10.12968/hmed.2024.0294. Epub 2024 Sep 13.
Pre-frailty is common in patients undergoing maintenance hemodialysis (MHD). Without proper management, it can quickly worsen and progress into frailty, leading to various adverse clinical outcomes. Therefore, timely interventions for pre-frail MHD patients are crucial. However, the response of pre-frail MHD patients to such interventions is currently unclear. This study evaluated the effect of a multicomponent intervention on changes in pre-frailty status, risk factors for frailty, quality of life, and clinical outcomes in pre-frail patients undergoing MHD. Sixty MHD patients were randomly assigned to intervention (received a 12-week multicomponent intervention) and control (received standard care) groups, with 30 participants per group, between February and May 2018. Data were collected at baseline and at 3 and 9 months thereafter. Analyzed outcomes included changes in pre-frailty status, frailty risk factors (such as albumin level, pain, and anxiety), quality of life, and clinical outcomes during the follow-up period. Data from a total of 58 MHD patients were collected at three time points. At week 12, frailty scores were 0.9 points lower in the intervention group compared to the control group ( = 0.007). The intervention group showed a 26.2% higher proportion of patients who improved from pre-frailty to non-frailty compared to the control group ( = 0.029), and a 25.9% lower proportion of patients who progressed from pre-frailty to frailty ( = 0.021). Additionally, improvements in albumin levels, pain, anxiety, and quality of life were more significant in the intervention group (all < 0.05). Although there were fewer incidents of falls and rehospitalizations in the intervention group during follow-up, these differences did not reach statistical significance (all > 0.05). This study validates the effectiveness and practicality of a multicomponent intervention in improving pre-frailty status, frailty risk factors, and quality of life in patients undergoing MHD. Chinese Clinical Trial Registry (ChiCTR-IOR-17012176).
衰弱前期在维持性血液透析（MHD）患者中较为常见。如果不加以适当的管理，它可能会迅速恶化并进展为衰弱，导致各种不良的临床结局。因此，及时干预衰弱前期 MHD 患者至关重要。然而，目前尚不清楚衰弱前期 MHD 患者对这些干预措施的反应。本研究评估了多组分干预对 MHD 衰弱前期患者衰弱前期状态、衰弱风险因素、生活质量和临床结局的变化的影响。
2018 年 2 月至 5 月期间，将 60 名 MHD 患者随机分配到干预组（接受 12 周的多组分干预）和对照组（接受标准护理），每组 30 名患者。在基线时和之后的 3 个月和 9 个月收集数据。分析结果包括衰弱前期状态、衰弱风险因素（如白蛋白水平、疼痛和焦虑）、生活质量和随访期间的临床结局的变化。
共收集了 58 名 MHD 患者在三个时间点的数据。在第 12 周时，与对照组相比，干预组的衰弱评分降低了 0.9 分（ = 0.007）。与对照组相比，干预组有 26.2%的患者从衰弱前期改善为非衰弱（ = 0.029），而有 25.9%的患者从衰弱前期进展为衰弱（ = 0.021）。此外，干预组白蛋白水平、疼痛、焦虑和生活质量的改善更为显著（均<0.05）。虽然在随访期间干预组的跌倒和再住院事件较少，但这些差异没有达到统计学意义（均>0.05）。
本研究验证了多组分干预在改善 MHD 患者衰弱前期状态、衰弱风险因素和生活质量方面的有效性和实用性。
中国临床试验注册中心（ChiCTR-IOR-17012176）。
