摘要
目的探究衰弱指数对老年冠心病患者出院半年内不良事件的预测价值。方法选取2020年1月~2022年1月期间在首都医科大学附属北京积水潭医院就诊并确诊为冠心病的184例老年患者,所有患者进行衰弱指数评估,并在出院后进行6个月的随访,按照是否衰弱分为衰弱组、非衰弱组。通过查阅患者的门诊及住院记录,以及电话随访,追踪记录患者6个月内的再住院情况、全因死亡、再发急性心肌梗死及大出血情况。结果184例患者中,96例衰弱指数(0.68±0.12),88例衰弱指数(0.14±0.02),衰弱发生率52.17%。衰弱组96例、非衰弱组88例,两组患者年龄、性别、体质量指数(BMI)、吸烟史、饮酒史、高血压、糖尿病和冠心病方面差异无统计学意义(P>0.05)。而衰弱组中心功能Ⅰ级的患者占2%,Ⅱ级的患者占60.4%,Ⅲ级的患者占27.1%,Ⅳ级的患者占10.4%。非衰弱组中心功能Ⅰ级的患者占13.6%,Ⅱ级的患者占62.5%,Ⅲ级的患者占20.5%,Ⅳ级的患者占3.4%。两组患者间心功能分级比较差异有统计学意义(χ^(2)=5.863,P=0.017),其中Ⅰ级和Ⅳ级的比例在衰弱组中较高。两组患者间并发症比较差异无统计学意义(P>0.05)。衰弱组有9例(9.38%)患者发生再发急性心肌梗死,4例(4.17%)发生大出血,8例(8.33%)发生全因死亡,3例(3.12%)患者需要再次住院。两组大出血、全因死亡、再住院次数比较差异有统计学意义(χ^(2)=4.990、3.990、3.260、6.356,P<0.05)。logistic回归分析发现,衰弱指数是老年冠心病患者6个月内再住院、全因死亡、急性心肌梗死、大出血的独立预测因素(P<0.05)。结论衰弱指数与老年冠心病患者6个月内再住院、全因死亡、急性心肌梗死、大出血方面显著相关,是其独立预测因素。临床对于此类老年冠心病出院后,仍应重视对衰弱患者的管理和监护,专门针对冠心病患者的衰弱指数研究,并对患者予以特定的康复训练、营养�
Objective This study aims to explore the predictive value of the frailty index on adverse events in elderly patients with coronary heart disease six months after discharge.Methods A total of 184 elderly patients diagnosed with coronary heart disease were included in the study from January 2020 to January 2022.The patients were divided into two groups:a non-frail group and a frail group,according to their Fried frailty criteria.The follow-up period lasted for 6 months after discharge.The rehospitalization rate,all-cause mortality,acute myocardial infarction,and major bleeding events were recorded through outpatient and inpatient records and telephone interviews.Results A total of 96 patients were classified as frail(52.17%)with a frailty index of(0.68±0.12),while 88 patients were non-frail(47.83%)with a frailty index of(0.14±0.02).There were no significant differences in age,gender,BMI,smoking history,drinking history,hypertension,diabetes,and coronary heart disease between the two groups(P>0.05).However,there was a significant difference in heart function between the two groups,with 96 patients in the frail group(2%in classⅠ,60.4%in classⅡ,27.1%in classⅢ,and 10.4%in classⅣ)and 88 patients in the non-frail group(13.6%in classⅠ,62.5%in classⅡ,20.5%in classⅢ,and 3.4%in classⅣ)(χ^(2)=5.863,P=0.017).There were no significant differences in the incidence of common complications between the two groups(P>0.05).During the 6-month follow-up period,9 patients(9.38%)in the frail group developed recurrent acute myocardial infarction,4 patients(4.17%)developed major bleeding,and 8 patients(8.33%)died.In the non-frail group,3 patients(3.12%)were rehospitalized due to recurrent acute myocardial infarction or major bleeding events,with a significant difference between the two groups(χ^(2)=4.990,P=0.019).Logistic regression analysis showed that the frailty index was an independent predictor of rehospitalization,all-cause mortality,acute myocardial infarction,and major bleeding events within 6 months in elderly
作者
葛佳
徐新娜
朱林
陈游州
Ge Jia;Xu Xinna;Zhu Lin(Department of Cardiology,Beijing Jishuitan Hospital Affiliated to Capital Medical University,Beijing 102208,China)
出处
《中华保健医学杂志》
2024年第2期147-150,共4页
Chinese Journal of Health Care and Medicine
基金
国家自然科学基金项目(81700330)。
关键词
衰弱指数
老年
冠心病
不良事件
预测
Frailty index
Elderly
Coronary heart disease
Adverse events
Prediction
