75岁以上经皮冠状动脉介入治疗后患者衰弱现状及影响因素分析

Analysis of the current status and influencing factors of frailty in patients over 75 years old after percutaneous coronary intervention

  • 摘要:
    目的 系统性分析75岁以上经皮冠状动脉介入治疗(PCI)后患者衰弱发生的独立影响因素。
    方法 采用便利抽样法选取2024年3—8月西京医院接受PCI的75岁以上患者278例为研究对象。收集患者社会人口学资料、疾病相关资料、实验室和影像学检查相关指标,术后至出院前采用Fried衰弱表型、Katz指数、工具性日常生活活动能力(IADL)量表、Charlson共病指数、Morse跌倒评估量表、微型营养评定简表(MNA-SF)及简易老年抑郁量表(GDS-15)进行综合评估。采用单因素分析和多因素Logistic回归模型筛选衰弱的影响因素。
    结果 Fried衰弱表型评估结果显示,衰弱患者145例(衰弱组),非衰弱患者133例(非衰弱组)。单因素分析显示,衰弱组与非衰弱组在年龄、性别、独居情况、血红蛋白、N末端脑钠肽前体(NT-proBNP)、左心室射血分数(LVEF)、IADL量表得分、营养状况、跌倒风险、抑郁程度方面差异有统计学意义(P < 0.05)。多因素Logistic回归分析表明,年龄较高(OR=1.167, 95%CI: 1.048~1.300)、跌倒风险较大(OR=1.597, 95%CI: 1.082~2.358)、抑郁程度高(OR=3.610, 95%CI: 1.710~7.623)是衰弱的独立危险因素,而IADL量表得分高(OR=0.575, 95%CI: 0.412~0.802)、良好营养状况(OR=0.399, 95%CI: 0.219~0.725)是其独立保护因素(P < 0.05)。
    结论 75岁以上PCI后患者发生衰弱受年龄、功能状态、营养水平、跌倒风险及心理状态等多方面因素影响。临床应重视此类患者围术期及出院后长期管理,并实施多维度综合干预以延缓衰弱进程。

     

    Abstract:
    Objective To systematically analyze the independent influencing factors of frailty in patients over 75 years old after percutaneous coronary intervention (PCI).
    Methods A total of 278 patients over 75 years old who underwent PCI at Xijing Hospital from March to August 2024 were selected as the research subjects using the convenience sampling method. Social demographic data, disease-related data, laboratory and imaging examination indicators of the patients were collected. Comprehensive assessments were conducted from post-operation to before discharge using the Fried frailty phenotype, Katz index, Instrumental Activities of Daily Living (IADL) scale, Charlson comorbidity index, Morse fall Assessment Scale, Mini-nutritional Assessment Short-form (MNA-SF), and simplified Geriatric Depression Scale (GDS-15). Univariate analysis and multivariate logistic regression models were used to screen the influencing factors of frailty.
    Results According to the Fried frailty phenotype assessment results, therewere 145 cases with frailty(frailty group) and 133 cases without frailty(non-frailty group). Univariate analysis showed that there were significant differences between the frailty group and the non-frailty group in terms of age, gender, living alone status, hemoglobin, N-terminal pro-brain natriuretic peptide (NT-proBNP), left ventricular ejection fraction (LVEF), IADL scale score, nutritional status, fall risk, and depression level (P < 0.05). Multivariate logistic regression analysis indicated that older age (OR=1.167, 95%CI, 1.048 to 1.300), higher fall-risk (OR=1.597, 95%CI, 1.082 to 2.358), and higher depression level (OR=3.610, 95%CI, 1.710 to 7.623) were indenpendent risk factors for frailty, while a high IADL scale score (OR=0.575, 95%CI, 0.412 to 0.802) and good nutritional status (OR=0.399, 95%CI, 0.219 to 0.725) were indenpendent protective factors (P < 0.05).
    Conclusion The occurrence of frailty in patients over 75 years old after PCI is influenced by multiple factors such as age, functional status, nutritional level, fall risk, and psychological status. Clinical attention should be paid to the long-term perioperative and post-discharge management of such patients, and multidimensional comprehensive interventions should be implemented to delay the progression of frailty.

     

/

返回文章
返回