摘要
目的探讨衰弱评估联合Killip分级对急性心肌梗死老年患者行择期冠状动脉介入术后并发症的预测价值。方法依据Fried衰弱表型量表评估某省三级甲等医院心内科302例行择期冠状动脉介入术(PCI)的急性心肌梗死(AMI)老年患者衰弱状况,并收集患者Killip心功能分级、一般临床资料以及住院期间术后并发症的发生情况,比较衰弱和非衰弱患者术后并发症发生率。通过受试者工作特征(ROC)曲线,评价衰弱评估联合Killip分级以及单独应用衰弱评估和Killip分级对行择期PCI的老年AMI患者术后并发症的预测效果。结果同等Killip分级下,衰弱的老年急性心肌梗死患者术后并发症发生率高(P<0.05);衰弱评估联合Killip分级预测PCI术后并发症的ROC曲线下面积(AUC)为0.891,显著高于单独应用衰弱评估及Killip分级的0.816、0.802(P<0.05),对应的灵敏度和特异度分别为88.6%、84.8%。结论衰弱会增加老年AMI患者行择期PCI术后并发症的发生率;衰弱评估联合应用Killip分级可有效预测老年AMI患者PCI术后并发症的发生,护士及家属在术前对患者进行衰弱评估可辅助临床医生及患者本人对其术后的安全管理。
Objective To explore the predictive value of the combination of frailty assessment and Killip grade in elderly patients with acute myocardial infarction after percutaneous coronary intervention(PCI).Methods We evaluated the frailty condition of 302 AMI patients with PCI in the cardiology department of the province Grade 3A hospital according to the fried frailty phenotype scale,collected the patients'Killip grade,general clinical data and the occurrence of postoperative complications during hospitalization,and compared the incidence of postoperative complications in frailty and non-frailty patients.What's more,we evaluated the effect of the combination of frailty assessment and Killip grade,frailty assessment and Killip grade on postoperative complications of elderly AMI patients with PCI by working characteristic curve(ROC).Results Under the same Killip grade,the incidence of postoperative complications of frailty patients was high(P<0.05).The area under curve(AUC)of the combination of frailty assessment and Killip grade predicting PCI postoperative complications was 0.891,significantly higher than 0.816 of frailty assessment and 0.802 of Killip grade(P<0.05),and the corresponding sensitivity and specificity was respectively 88.6%and 84.8%.Conclusion Frailty can increase the incidence of PCI postoperative complications in elderly AMI patients.The combination of frailty assessment and Killip grade can effectively predict the occurrence of PCI postoperative complications AMI patients,preoperative frailty assessment of patients by nurses and families of patients can assist clinicians and patients to manage patients'postoperative safety.
作者
王艺璇
宋琼
颜琬华
WANG Yixuan;SONG Qiong;YAN Wanhua(School of Nursing, Binzhou Medical University, Binzhou 256600;Department of Cardiovascular Medicine, Affiliated Hospital of Binzhou Medical University, Binzhou 256600 China.)
出处
《中国老年保健医学》
2021年第1期23-26,共4页
Chinese Journal of Geriatric Care
基金
山东省医药卫生科技计划项目(2016WS0030)
滨州医学院附属医院科技计划项目(BY2014KJ37)。
关键词
衰弱评估
KILLIP分级
急性心肌梗死
冠状动脉介入术
术后并发症
frailty assessment
Killip grade
acute myocardial infarction
percutaneous coronary intervention
postoperative complications
