摘要
目的 本研究旨在探讨老年住院患者中高血压合并衰弱状态与口腔健康状况之间的相关性及其对临床预后的影响.方法 选取2021年1月至2022年1月于首都医科大学电力教学医院老年医学科接受治疗的160例老年高血压患者,根据Fried量表将患者分为高血压合并衰弱组(n=72)和未合并衰弱组(n=88).对比两组患者的一般资料,包括性别、年龄、体质指数(BMI)、吸烟史、饮酒史、脉压差、总胆固醇(TC)、三酰甘油(TG)、促甲状腺激素(TSH)、空腹血糖(FPG)、多重用药、义齿使用情况以及老年口腔健康评价指数(GOHAI)评分等方面的差异.对存在显著差异的指标进一步进行组间差异分析及多因素logistic回归分析,以探讨住院老年高血压合并衰弱与口腔健康之间的关系.两组患者均接受为期1年的随访,比较再住院率及全因死亡率.结果 与未合并衰弱组相比,高血压合并衰弱组患者在年龄、脉压差、多重用药、义齿使用等方面显著增高(P<0.05),而BMI、TC及GOHAI评分显著降低(P<0.05).多因素Logistic回归分析显示,BMI值低、义齿使用率高、多重用药及低GOHAI评分是住院老年高血压患者合并衰弱的独立危险因素(P<0.05).此外,高血压合并衰弱组的1年内再住院率显著高于未合并衰弱组(P<0.05).结论 住院老年高血压患者的衰弱状态与BMI值低、义齿使用率高、多重用药及口腔健康状况不佳密切相关,且口腔健康不良可增加衰弱风险和再住院率.因此,识别与筛查老年高血压患者的口腔健康问题,并采取积极的干预措施,对于延缓衰老、改善患者预后具有重要意义.
Abstract
Objective This study aims to investigate the association between frailty and oral health status in elderly inpatients with hypertension and its impact on clinical prognosis.Method A total of 160 elderly hypertensive patients treated at the Geriatric Department of Electric Power Teaching Hospital of Capital Medical University from January 2021 to January 2022 were selected.According to the Fried scale,the patients were divided into a hypertension with frailty group (n=72) and a non-frailty group (n=88).General information of the two groups was compared,including sex,age,body mass index (BMI),smoking history,drinking history,pulse pressure,total cholesterol (TC),triglycerides (TG),thyroid-stimulating hormone (TSH),fasting plasma glucose (FPG),polypharmacy,denture use,and Geriatric Oral Health Assessment Index (GOHAI) scores.Indicators with significant differences were further analyzed using intergroup difference analysis and multivariate logistic regression to explore the relationship between frailty and oral health in elderly hypertensive inpatients.All patients underwent a 1-year follow-up,and the rehospitalization rate and all-cause mortality were compared between the two groups.Results Compared to the non-frailty group,patients in the frailty group had significantly higher age,pulse pressure,polypharmacy,and denture use (P＜0.05),while BMI,TC,and GOHAI scores were significantly lower (P＜0.05).Multivariate logistic regression analysis showed that low BMI,high denture usage rate,polypharmacy,and low GOHAI scores were independent risk factors for frailty in elderly hypertensive inpatients (P＜0.05).In addition,the 1-year rehospitalization rate was significantly higher in the frailty group thanin the non-frailty group (P＜0.05).Conclusion The frailty status of hospitalized elderly hypertensive patients is closely associated with low BMI,high denture usage,polypharmacy,poor oral health status,and poor oral health may increase the risk of frailty and rehospitalization.Therefore,identifying and screening oral health issues in elderly hypertensive patients,as well as taking proactive interventions,are of great importance in delaying aging and improving patient prognosis.
维普
万方数据