Jiang Heyue, Pan Longfang, Yang Yuanyuan, Hong Yueling
Nursing Department, The First Affiliated Hospital of Chongqing Medical University, Medical College Road, Chongqing, 400016, China.
Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, Medical College Road, Chongqing, 400016, China.
Sci Rep. 2025 Apr 28;15(1):14830. doi: 10.1038/s41598-025-99555-y.
Frailty is highly prevalent in elderly patients with chronic obstructive pulmonary disease (COPD), contributing to poor clinical outcomes and reduced quality of life. To examine the effects of grip strength, CAT score, multimorbidity, GOLD stage, and age on frailty for hospitalised elderly with COPD through path analysis. This cross-sectional study used convenience sampling to select 283 hospitalised patients from March to August 2024. Path analysis explored the direct and indirect effects among grip strength, CAT score, multimorbidity, GOLD stage, and age. Grip strength was measured with a digital dynamometer, CAT score assessed disease impact, multimorbidity was based on patient-reported diagnoses, and GOLD stage was determined by pulmonary function tests. Among 283 hospitalised elderly COPD patients, the prevalence of frailty was 33.92%. The path analysis model showed good fit (χ/df = 1.170, RMSEA = 0.027, 90% CI = 0.024-0.085, CFI = 0.992, TLI = 0.982, SRMR = 0.051, GFI = 0.981). Grip strength was the strongest predictor of frailty, followed by multimorbidity. The model explained 46.9% of the variance in frailty, with grip strength accounting for 11.2%. Hospitalised elderly patients with COPD who exhibited low grip strength, high CAT score, advanced age, multimorbidity, and a higher GOLD stage were more likely to experience frailty. These findings suggest that interventions aimed at improving grip strength and managing multimorbidity may help alleviate frailty in elderly COPD patients.
衰弱在慢性阻塞性肺疾病（COPD）老年患者中非常普遍，会导致不良的临床结局和生活质量下降。通过路径分析来研究握力、CAT评分、多病共存、GOLD分级和年龄对住院COPD老年患者衰弱的影响。这项横断面研究采用便利抽样法，从2024年3月至8月选取了283例住院患者。路径分析探讨了握力、CAT评分、多病共存、GOLD分级和年龄之间的直接和间接影响。用数字测力计测量握力，CAT评分评估疾病影响，多病共存基于患者报告的诊断，GOLD分级由肺功能测试确定。在283例住院COPD老年患者中，衰弱的患病率为33.92%。路径分析模型显示拟合良好（χ/df = 1.170，RMSEA = 0.027，90%CI = 0.024 - 0.085，CFI = 0.992，TLI = 0.982，SRMR = 0.051，GFI = 0.981）。握力是衰弱最强的预测因素，其次是多病共存。该模型解释了衰弱变异的46.9%，其中握力占11.2%。握力低、CAT评分高、年龄大、多病共存且GOLD分级较高的住院COPD老年患者更易出现衰弱。这些发现表明，旨在提高握力和管理多病共存的干预措施可能有助于减轻COPD老年患者的衰弱。
