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急性结石性胆囊炎住院老年患者身体衰弱的危险因素及预测列线图

Risk factors for and a prediction nomogram of physical frailty in older patients hospitalized with acute calculous cholecystitis.

作者信息

Deng Yi, Hu Xiaofeng, Hirano Yuma, Liao Rui, Takashima Shunji, Zhang Keming, Nagafusa Tetsuyuki, Zhu Jiali, Yamauchi Katsuya

机构信息

Graduate School of Rehabilitation Medicine, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan.

Department of Nursing, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China.

出版信息

Glob Health Med. 2025 Aug 31;7(4):294-305. doi: 10.35772/ghm.2025.01075.

Abstract

Frailty increases the risk of complications and delays recovery in older patients with acute calculous cholecystitis (ACC). Early identification is crucial to improving outcomes. Subjects were 386 older inpatients with ACC at two hospitals who were randomly divided into a training set ( = 270) and validation set ( = 116). Patients were categorized into frail and non-frail groups. Binary logistic regression identified significant predictors, and a nomogram was developed. The incidence of frailty was 27% ( = 73). Smoking, a sleep disorder, impaired ADL, and malnutrition were independent predictors for frailty ( < 0.05). The nomogram showed good discrimination (AUC = 0.752), with a sensitivity of 82.6% and a specificity of 67.4%. Calibration was acceptable (Hosmer-Lemeshow ² = 4.407, = 0.732), and decision curve analysis demonstrated clinical utility. The developed nomogram reliably predicts the risk of frailty in older patients with ACC and may facilitate targeted early interventions in clinical practice.

摘要

衰弱会增加老年急性结石性胆囊炎(ACC)患者出现并发症的风险,并延缓康复。早期识别对于改善预后至关重要。研究对象为两家医院的386例老年ACC住院患者,他们被随机分为训练集(n = 270)和验证集(n = 116)。患者被分为衰弱组和非衰弱组。二元逻辑回归确定了显著的预测因素,并绘制了列线图。衰弱的发生率为27%(n = 73)。吸烟、睡眠障碍、日常生活活动能力受损和营养不良是衰弱的独立预测因素(P < 0.05)。列线图显示出良好的区分度(AUC = 0.752),灵敏度为82.6%,特异度为67.4%。校准可接受(Hosmer-Lemeshow检验χ² = 4.407,P = 0.732),决策曲线分析证明了其临床实用性。所绘制的列线图能够可靠地预测老年ACC患者的衰弱风险,并可能有助于在临床实践中进行有针对性的早期干预。

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