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中华老年病研究电子杂志 ›› 2017, Vol. 04 ›› Issue (02) : 43 -47. doi: 10.3877/cma.j.issn.2095-8757.2017.02.008

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临床研究

基于老年综合评估体系构建的衰弱指数模型在老年住院患者中的应用
孙凯旋1, 刘永兵1, 薛谨1, 侯萍1, 吴琳凤1, 薛玲玲1, 薛慧萍1, 史宏灿2,()   
  1. 1. 225001 扬州大学护理学院
    2. 225001 扬州大学医学院
  • 收稿日期:2017-03-02 出版日期:2017-05-28
  • 通信作者: 史宏灿
  • 基金资助:
    扬州市重点研发计划(社会发展)项目(YZ2015054); 扬州大学"高端人才支持计划"项目(201431)

Application of frailty index based on a comprehensive geriatric assessment in hospitalized elderly patients

Kaixuan Sun1, Yongbing Liu1, Jin Xue1, Ping Hou1, Linfeng Wu1, Lingling Xue1, Huiping Xue1, Hongcan Shi2,()   

  1. 1. Nursing College of Yangzhou University, YangZhou 225001, China
    2. Medical College of Yangzhou University, YangZhou 225001, China
  • Received:2017-03-02 Published:2017-05-28
  • Corresponding author: Hongcan Shi
  • About author:
    Corresponding author: Shi Hongcan, Email:
引用本文:

孙凯旋, 刘永兵, 薛谨, 侯萍, 吴琳凤, 薛玲玲, 薛慧萍, 史宏灿. 基于老年综合评估体系构建的衰弱指数模型在老年住院患者中的应用[J/OL]. 中华老年病研究电子杂志, 2017, 04(02): 43-47.

Kaixuan Sun, Yongbing Liu, Jin Xue, Ping Hou, Linfeng Wu, Lingling Xue, Huiping Xue, Hongcan Shi. Application of frailty index based on a comprehensive geriatric assessment in hospitalized elderly patients[J/OL]. Chinese Journal of Geriatrics Research(Electronic Edition), 2017, 04(02): 43-47.

目的

探讨基于老年综合评估(comprehensive geriatric assessment, CGA)体系构建的衰弱指数(frailty index, FI)模型(FI-CGA)在老年住院患者中的应用。

方法

选取扬州大学医学院附属医院2016年7~11月收治的≥60岁的老年住院患者105例作为研究对象。依据CGA量表对所有老年住院患者进行评估,并计算出FI,同时应用临床衰弱量表(clinical frailty scale, CFS)对老年患者的健康状况进行测评,比较不同性别和年龄段(60~69岁、70~79岁、≥80岁)老年住院患者的FI-CGA及CFS分级情况,并分析FI-CGA与CFS的相关性。两组间的比较采用t检验,多组间的比较采用单因素方差分析,相关性采用Spearman相关分析。

结果

CGA评估显示,105例老年住院患者中超过半数有不同程度的握力、视力、听力等的下降,大多数患者自身健康状况一般或不好,近半数患者明显感觉疲乏;仅少部分患者有平衡异常;超过半数老年患者日常生活活动能力正常,但大部分患者社会参与程度低;绝大多数患者每日服用药物种数并不多。105例老年患者中男性患者FI-CGA为0.01~0.48(0.17±0.11),CFS分级为2~7(3.51±1.24);女性患者FI-CGA为0.05~0.57(0.21±0.11),CFS分级为2~7(3.69±1.23)。不同年龄段老年患者的GI-CGA及CFS分级的差异均有统计学意义(F=11.175、6.937,均P<0.01)。60~69岁者FI-CGA及CFS分级均明显低于70~79岁者及≥80岁者,而且≥80岁者FI-CGA及CFS分级均明显高于70~79岁者,差异均有统计学意义(均P<0.05)。老年人FI-CGA与CFS分级水平呈显著正相关(r=0.796,P<0.01)。其中60~69岁、70~79岁、≥80岁的各年龄段患者的FI-CGA与CFS均呈显著正相关(r=0.700、0.796、0.906,均P<0.01)。

结论

基于CGA构建的FI模型可以很好的评估老年住院患者的健康状况并量化衰弱程度,值得临床上推广使用。

Objective

The feasibility of frailty index based on a comprehensive geriatric assessment (CGA) in Chinese hospitalized elderly patients was explored and the frailty status was analyzed.

Methods

A total of 105 patients were interviewed using CGA and Clinical Frailty Scale-09 (CFS-09), and frailty index was calculated based on CGA (FI-CGA). Besides, the health status of hospitalized elderly patients was evaluated with CFS-09 and the correlation between FI-CGA and CFS level was analyzed. The comparison between the two groups was tested by t-test, and the comparison between groups was based on the single factor variance analysis, and the correlation was analyzed by Spearman correlation.

Results

The FI-CGA values of 105 patients was 0.01~0.57 and the average was 0.18±0.11; The CFS score of 105 patients was 2~7 and the mean was 3.56±1.24. The average FI-CGA and CFS was higher in female (FI-CGA: 0.05~0.57, 0.21±0.11; CFS: 2~7, 3.69±1.23) than in male (FI-CGA: 0.01~0.48, 0.17±0.11; CFS: 2~7, 3.51±1.24), but this difference was not statistically significant (t=-0.686, P > 0.05; t=-1.800, P > 0.05) . Both FI-CGA (F=11.175, P < 0.01) and CFS (F=6.937, P < 0.01) increased with age and FI-CGA was positively correlated with CFS in different age groups (60-69 group: r=0.700, P < 0.01; 70-79 group: r=0.796, P < 0.01; ≥80 group: r=0.906, P < 0.01).

Conclusion

FI-CGA model, a valid, reliable and sensible clinical measure, is capable of quantifying the degree of frailty and evaluating the health status of hospitalized elderly patients. This model is worthy to be widely applied to clinical geriatric medicine.

表1 105例老年患者的一般资料
表2 105例老年患者CGA结果分布情况
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