摘要
目的 探讨老年住院高血压患者衰弱发生情况、相关危险因素和衰弱对临床预后的影响。方法 选取2018年2月至2021年10月于首都医科大学附属北京友谊医院老年医学科住院治疗的老年高血压患者308例为研究对象,根据Fried评分将患者分为衰弱组(114例)、衰弱前期组(130例)和无衰弱组(64例)。比较3组患者的一般临床资料、超声心动和实验室检查指标,随访患者再住院和全因死亡发生情况,分析衰弱的危险因素和对预后的影响。结果 308例老年高血压患者衰弱组检出率为37.0%,衰弱前期组为42.2%,无衰弱组为20.8%。多因素logistic回归分析发现,与非衰弱组相比,体质指数(OR=0.778)、慢性肾脏病(OR=29.551)、血红蛋白(OR=0.952)和白蛋白(OR=0.821)是发生衰弱的独立危险因素(均为P<0.05);年龄(OR=1.082)、共病指数(OR=0.634)、慢性肾脏病(OR=38.685)和血红蛋白(OR=0.965)是发生衰弱前期的独立危险因素(均为P<0.05)。衰弱组再住院发生率高于衰弱前期和非衰弱组,多因素分析发现衰弱为再住院和全因死亡的独立危险因素(均为P<0.05)。结论 衰弱与老年高血压患者再入院和全因死亡有关,体质指数、血红蛋白、白蛋白和慢性肾脏病是发生衰弱的危险因素。
Objective To investigate the incidence of frailty,related risk factors and the effect of frailty on clinical prognosis in elderly hospitalized hypertensive patients.Methods A total of 308 elderly hypertensive patients who were hospitalized in the Department of Geriatrics,Beijing Friendship Hospital Affiliated to Capital Medical University from February 2018 to October 2021 were selected as the research objects.According to Fried score,the patients were divided into frailty group(114 cases),prefrailty group(130 cases) and non-frailty group(64 cases).The general clinical data,echocardiography and laboratory test indexes of the three groups of patients were compared,and the incidence of rehospitalization and all-cause mortality was followed up,and the risk factors of frailty and their impact on prognosis were analyzed.Results The detection rate of 308 elderly hypertensive patients was 37.0% in the frail group,42.2% in the prefrailty group,and 20.8% in the non-frail group.Multivariate logistic regression analysis found that compared with the non-frail group,body mass index(OR=0.778),chronic kidney disease(OR=29.551),hemoglobin(OR=0.952) and albumin(OR=0.821) were independent risk factors for frailty(all P<0.05);age(OR=1.082),comorbidity index(OR=0.634),chronic kidney disease(OR=38.685) and hemoglobin(OR=0.965) were independent risk factors for pre-frailty(all P<0.05).The incidence of readmission in the frail group was higher than that in the pre-frail and non-frail groups.Multivariate analysis found that frailty was an independent risk factor for readmission and all-cause death(both P<0.05).Conclusions Frailty is associated with readmission and all-cause mortality in elderly hypertensive patients,and body mass index,hemoglobin,albumin,and chronic kidney disease are risk factors for frailty.
作者
杜玲
孙颖
Du Ling;Sun Ying(Department of Geriatrics,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)
出处
《中国心血管杂志》
2022年第2期117-122,共6页
Chinese Journal of Cardiovascular Medicine
关键词
老年人
高血压
衰弱
危险因素
临床预后
Aged
Hypertension
Frailty
Risk factors
Clinical prognosis
