目的 评估老年住院患者的衰弱状态,并分析其影响因素.方法 选取2014年9月—2015年8月在重庆医科大学附属第二医院、贵州省遵义市第一人民医院、贵州省航天医院内科住院年龄≥60岁的1494例患者为研究对象.调查其一般人口学资料(性别、年龄、所受教育年限、婚姻状况、每月主要收入)、个人生活习惯及日常生活能力(吸烟、饮酒、自我健康评估)、疾病及服药情况(所患主要疾病、认知功能、抑郁、残疾、过去1年跌倒史、服药种类)、过去1年住院史及住院时间.并采用衰弱表型(FP)量表评估其衰弱状态.结果 1494例患者,排除拒绝调查(n=32)、交流障碍或重症患者无法完成调查(n=20)和缺失数据患者(n=42),共入选1400例患者.其中衰弱252例(18.0％),衰弱前期458例(32.7％),无衰弱690例(49.3％).多因素Logistic回归分析结果显示,年龄、体质指数(BMI)、婚姻状况、自我健康评估、过去1年住院史、抑郁、残疾、过去1年跌倒史是衰弱前期的影响因素(P<0.05);年龄、BMI、每月主要收入<1000元/月、自我健康评估、认知障碍、抑郁、残疾、过去1年跌倒史、服药数量是衰弱的影响因素(P<0.05).结论 多项人口学指标、疾病情况与衰弱相关,衰弱的治疗重在预防,其治疗应是涉及老年人生理、心理等多领域的综合干预手段.%Objective To assess the status and associated factors of frailty in older inpatients.Methods We enrolled 1494 internal medicine inpatients aged≥60 years from the Second Affiliated Hospital of Chongqing Medical University, the First People's Hospital of Zunyi, and Guizhou Aerospace Hospital from September 2014 to August 2015. They were surveyed by a questionnaire consisting of demographic data (sex, age, educational level, marital status, monthly income), living habit (prevalence of smoking and drinking) and activities of daily living (self-rated health), prevalence of disease and medications(number of comorbid conditions, status of cognitive function, prevalence of depression and physical disability, history of falling in the past year, number of medications),and history of hospitalization in the past year and hospitalization time. Phenotype of Frailty (FP) was used to evaluate the status of frailty.Results After excluding 32 cases who refused to participate in the survey, 20 cases who could not complete the survey due to communication impairments or serious illness, and 42 cases without complete data, a total of 1400 patients were finally enrolled. Of them, 252 (18.0％) were frail, 458 (32.7％) were pre-frail and 690 (49.3％) were non-frail. Multivariate Logistic regression analysis showed that, age, BMI, marital status, self-rated health, history of hospitalization in the past year, prevalence of depression and physical disability, and history of falling in the past year were the associated factors for pre-frailty (P<0.05) ; age, BMI, monthly income less than 1000 yuan, self-rated health, cognitive impairment, prevalence of depression and physical disability, history of falling in the past year and number of medications were the associated factors for frailty (P<0.05).Conclusion Numerous demographic indicators and disease state are significantly associated with frailty in older inpatients. In this population, prevention of frailty is a top priority. As for the treatment of frailty, comprehensive intervention involving physiological and psychological aspects is effective.
展开▼
