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老年患者消化系统腹部手术中的衰弱轨迹及其相关因素:一项纵向研究。

Frailty trajectory and its associated factors in older patients undergoing abdominal surgery involving the digestive system: A longitudinal study.

作者信息

Guo Jing, Wang Wenshuang, Zhang Xiaoxue, Zheng Yulin, Wang Xinran

机构信息

Department of General Surgery, Xuanwu Hospital, Capital Medical University, Beijing, China.

Nursing Department, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.

出版信息

PLoS One. 2025 Aug 8;20(8):e0330093. doi: 10.1371/journal.pone.0330093. eCollection 2025.

Abstract

Frailty is a common multifactorial clinical syndrome in older patients that seriously affects their prognosis. However, most studies to date have ignored the dynamics of frailty. Therefore, we employed a one-month observational longitudinal study to explore frailty trajectories using a latent class growth model. In total, 155 older patients who underwent abdominal surgery involving the digestive system were assessed preoperatively, at discharge, and at the one-month follow-up, and multiple logistic regression analysis was conducted to identify factors influencing frailty trajectories. Four frailty trajectory patterns were identified: no frailty (13.5%), frailty exacerbation (40.0%), frailty improvement (20.0%), and persistent frailty (26.5%). Logistic regression analysis revealed that body mass index, the Charlson comorbidity index score, the type of surgery, the intraoperative drainage tube retention time (drainage time), the first time the patient got out of bed after surgery, the time of the first oral feed after surgery, postoperative complications, mobility, nutritional risk, and anxiety were associated with frailty trajectories. We identified four frailty trajectories in older patients undergoing abdominal surgery involving the digestive system and found that these trajectories were influenced by multiple factors. Focusing on individual specificity is conducive to accurately addressing frailty-associated clinical problems and guiding relevant nursing decisions.

摘要

衰弱是老年患者中常见的多因素临床综合征,严重影响其预后。然而,迄今为止大多数研究都忽略了衰弱的动态变化。因此,我们采用了为期一个月的观察性纵向研究,使用潜在类别增长模型来探索衰弱轨迹。总共对155例接受涉及消化系统腹部手术的老年患者在术前、出院时和术后1个月随访时进行了评估,并进行了多因素逻辑回归分析以确定影响衰弱轨迹的因素。确定了四种衰弱轨迹模式:无衰弱(13.5%)、衰弱加重(40.0%)、衰弱改善(20.0%)和持续性衰弱(26.5%)。逻辑回归分析显示,体重指数、Charlson合并症指数评分、手术类型、术中引流管留置时间(引流时间)、患者术后首次下床时间、术后首次经口进食时间、术后并发症、活动能力、营养风险和焦虑与衰弱轨迹相关。我们在接受涉及消化系统腹部手术的老年患者中确定了四种衰弱轨迹,并发现这些轨迹受多种因素影响。关注个体特异性有助于准确解决与衰弱相关的临床问题并指导相关护理决策。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/441e/12334016/5e11429678e8/pone.0330093.g001.jpg

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