首页|老年慢性心力衰竭住院患者衰弱影响因素及风险预测模型构建研究

老年慢性心力衰竭住院患者衰弱影响因素及风险预测模型构建研究

Study on the influence factors of frailty and the construction of risk prediction model in elderly inpatients with chronic heart failure

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目的 探讨老年慢性心力衰竭住院患者衰弱影响因素,构建衰弱风险预测模型,为预防和减少衰弱提供临床参考依据.方法 采用便利抽样法选择2022年3月一2023年3月阜阳市第五人民医院心血管科住院的198例老年慢性心力衰竭患者作为研究对象,根据是否发生衰弱分成衰弱组及非衰弱组.采用二元logistic回归分析衰弱的影响因素,通过Hosmer-Lemeshow检验和ROC曲线分别检测模型拟合优度和预测效果.结果 老年慢性心力衰竭住院患者衰弱发生率为32.32%(64/198),疲劳为最主要症状(51.01%,101/198).年龄(OR=1.101,P=0.007)、NYHA 心功能分级(OR=2.550,P=0.011)、病程(OR=2.210,P=0.014)、睡眠状态(OR=2.215,P=0.010)、N末端脑钠肽前体(OR=1.003,P<0.001)、左心室射血分数(OR=0.910,P<0.001)及自我管理水平(OR=0.229,P<0.001)均是衰弱发生的影响因素.回归模型有较好的拟合优度(x2=2.915,P=0.940),AUC为0.913(P<0.001,95%CI:0.870~0.956),灵敏度为89.1%,特异度为81.3%.结论 老年慢性心力衰竭住院患者衰弱发生率较高,临床应重视高龄、心功能差、病程长、睡眠质量差及自我管理能力低的患者.该研究构建的老年慢性心力衰竭住院患者衰弱风险预测模型效果较好,可为患者衰弱风险评估及干预提供参考依据.
Objective To explore the influencing factors of frailty in elderly patients with chronic heart failure,and build a frailty risk prediction model to provide clinical reference for preventing and reducing frailty.Methods A total of 198 elderly patients with chronic heart failure who were hospitalized in the cardiovascular Department of the Fifth People's Hospital of Fuyang from March 2022 to March 2023 were selected by convenience sampling method.They were divided into a frailty group and a non-frailty group according to whether frailty occurred.The influencing factors of frailty were an-alyzed by binary Logistic regression.Hosmer-Lemeshow test and ROC curve were used to detect the goodness of fit and prediction effect respectively.Results The incidence of frailty in elderly CHF patients was 32.32%(64/198),and fa-tigue was the main symptom(51.01%,101/198).Age(OR=1.101,P=0.007),NYHA cardiac function grade(OR=2.550,P=0.011),course of disease(OR=2.210,P=0.014),sleep state(OR=2.215,P=0.010),N-ter-minal brain natriuretic peptide precursor(OR=1.003,P<0.001),left ventricular ejection fraction(OR=0.910,P<0.001)and self-management level(OR=0.229,P<0.001)were influencing factors in the occurrence of frailty.The re-gression model had good goodness of fit(x2=2.915,P=0.940),and the AUC under the ROC curve was 0.913(P<0.001,95%CI:0.870-0.956),sensitivity was 89.1%,specificity was 81.3%.Conclusion The incidence of frailty in elderly patients with chronic heart failure is high.Clinical attention should be paid to elderly patients with poor heart function,long course of disease,poor sleep quality,and low self-management ability.The frailty risk prediction model established in this study is effective in elderly patients with chronic heart failure,which can provide a reference for frailty risk assessment and intervention.

Chronic heart failureFrailtyOld ageInfluencing factorsRisk prediction model

谭杰、陈曼曼、陈凌云、黄宇理

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阜阳市第五人民医院心血管科,安徽阜阳 236000

蚌埠医科大学第一附属医院心血管科,安徽蚌埠 233004

慢性心力衰竭 衰弱 老年 影响因素 风险预测模型

安徽省教育厅人文社会科学研究重点项目

SK2020A0351

2024

中华全科医学
中华预防医学会,安徽省全科医学会

中华全科医学

CSTPCD
影响因子:1.688
ISSN:1674-4152
年,卷(期):2024.22(6)