摘要
目的调查老年慢性阻塞性肺疾病患者衰弱情况,分析COPD衰弱与患者预后、再住院率的关系。方法选择老年COPD患者435例,临床衰弱水平量表(CFS)调查衰弱发生情况,随访6个月统计不良事件及再住院率,筛选COPD预后、再住院率影响因素。结果老年COPD患者衰弱检出率为38.39%。衰弱组年龄≥70岁(82.04%)、合并脑梗死(26.95%)、病程≥10年(47.31%)、COPD分级为Ⅳ级(38.92%)、长期用药>4种类型(41.32%)患者所占比例高于非衰弱组(57.46%、13.43%、31.72%、20.15%、19.78%)(P<0.05),随访期间不良事件发生率(24.55%)及再住院率(64.07%)高于非衰弱组(5.97%、10.82%)(P<0.05);年龄(Or=2.192、2.257,95%CI:1.051~4.572、1.008~5.051)、COPD分级(Or=3.557、3.238,95%CI:1.788~7.078、1.583~6.622)、长期服药数量(Or=5.789、4.831,95%CI:2.102~15.948、1.346~17.338)、衰弱(Or=23.689、19.453,95%CI:6.727~89.468、6.025~62.808)均为导致COPD随访期间不良事件发生及再住院的相关危险因素(P<0.05)。结论老年COPD患者衰弱发生率较高;高龄、长病程、高COPD分级、长期服用多种药物、合并脑梗死COPD患者,更易患衰弱;衰弱与年龄、长期服药数量、COPD分级均为影响老年COPD患者预后及再住院率的相关因素。
Objective To investigate the situation of frailty in elderly patients with chronic obstructive pulmonary disease(COPD)and analyze its relationship with the prognosis and readmission rate.Methods 435 elderly patients with COPD were investigated for the occurrence of frailty with the clinical frailty scale(CFS).Adverse events and readmission rate during 6 months of follow-up were statistically analyzed.Factors affecting the prognosis and readmission rate of patients with COPD were screened.Results The detection rate of frailty in this study was 38.39%.The proportions of patients≥70 years old(82.04%),complicated with cerebral infarction(26.95%),course of disease≥10 years(47.31%),gradeⅣCOPD(38.92%)and long-term medication>4 kinds of drugs(41.32%)in the frailty group were higher than those in the non-frailty group(57.46%,13.43%,31.72%,20.15%,19.78%)(P<0.05).The incidence of adverse events and readmission rate in the frailty group during follow-up(24.55%and 64.07%)were higher than those in the non-frailty group(5.97%and 10.82%)(P<0.05).Age(Or=2.192,2.257,95%CI:1.051~4.572,1.008~5.051),grade of COPD(Or=3.557,3.238,95%CI:1.788~7.078,1.583~6.622),number of drugs used for long-term medication(Or=5.789,4.831,95%CI:2.102~15.948,1.346~17.338)and frailty(Or=23.689,19.453,95%CI:6.727~89.468,6.025~62.808)were related risk factors for adverse events and readmission in patients with COPD during follow-up(P<0.05).Conclusion The incidence of frailty in elderly patients with COPD is high.Those patients with advanced age,long course of disease,high COPD grade,long-term use of multiple drugs and with cerebral infarction are more prone to have frailty.Frailty,age,number of drugs used for long-term medication and grade of COPD all are related factors affecting the prognosis and readmission rate of elderly patients with COPD.
作者
宋希
申玉英
吴会玲
王积慧
王娅娜
SONG Xi;SHEN Yu-ying;WU Hui-ling;WANG Ji-hui;WANG Ya-na(Department of General Practice,Nanjing First Hospital,Nanjing Medical University,Nanjing,Jiangsu 210006,China)
出处
《临床肺科杂志》
2021年第6期885-890,共6页
Journal of Clinical Pulmonary Medicine
关键词
慢性阻塞性肺疾病
老年
衰弱
再住院
预后
chronic obstructive pulmonary disease
elderly
frailty
readmission
prognosis
