| 王丹蕾,张 蓉,吴 琪,夏绘绘,夏佩佩.基于Tilburg衰弱评估量表评价的老年慢性心力衰竭合并衰弱的危险因素探讨及其对患者生活质量和预后的影响[J].,2023,(16):3077-3082 |
| 基于Tilburg衰弱评估量表评价的老年慢性心力衰竭合并衰弱的危险因素探讨及其对患者生活质量和预后的影响 |
| Exploring the Risk Factors of Elderly Patients with Chronic Heart Failure Complicated with Frailty Based on Tilburg Frailty Assessment Scale and its Impact on Patients' Quality of Llife and Prognosis |
| 投稿时间：2022-12-07 修订日期：2022-12-30 |
| DOI：10.13241/j.cnki.pmb.2023.16.015 |
| 中文关键词: 老年 慢性心力衰竭 衰弱 危险因素 Tilburg衰弱评估量表 生活质量 预后 |
| 英文关键词: Elderly Chronic heart failure Frailty Risk factors Tilburg frailty assessment scale Quality of life Prognosis |
| 基金项目:江苏省临床医学科技专项项目（BL20150673） |
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| 中文摘要: |
| 摘要 目的：基于Tilburg衰弱评估量表评价老年慢性心力衰竭（CHF）的衰弱状况，分析影响衰弱的危险因素，并探讨其对患者生活质量和预后的影响。方法：选取2020年3月～2022年3月我院收治的102例老年CHF患者，根据Tilburg衰弱评估量表分为衰弱组与非衰弱组。收集患者基线资料，采用明尼苏达州心力衰竭生活质量问卷（MLHFQ）评分评估患者的生活质量，采用多因素Logistic回归分析老年CHF患者合并衰弱的危险因素，Spearman相关性分析衰弱组Tilburg衰弱评估量表评分与MLHFQ评分的相关性，比较两组患者生活质量和90 d非计划再入院率、死亡率。结果：102例老年CHF患者合并衰弱的发生率为53.92％（55/102）。多因素Logistic回归分析显示：体质指数（BMI）降低、NYHA心功能分级Ⅲ～Ⅳ级、合并疾病数量增加、血红蛋白（Hb）降低、红细胞分布宽度（RDW）升高、白蛋白（Alb）降低、N末端B型脑钠肽前体（NT-ProBNP）升高为老年CHF患者合并衰弱的独立危险因素（P＜0.05）。衰弱组MLHFQ身体领域、情绪领域、其他领域评分高于非衰弱组（P＜0.05）。Spearman相关性分析显示，老年CHF患者合并衰弱患者Tilburg衰弱评估量表评分与MLHFQ身体领域、情绪领域、其他领域评分呈正相关（rs=0.505、0.424、0.526，P均＜0.001）。随访90 d，衰弱组非计划再入院率高于非衰弱组（P＜0.05）。结论：老年CHF患者衰弱状况发生率较高，BMI、NYHA心功能分级、合并疾病数量、Hb、RDW、Alb、NT-ProBNP为老年CHF患者合并衰弱的影响因素，衰弱可导致患者生活质量下降和预后不良。Tilburg衰弱评估量表能快速评价老年CHF患者合并衰弱状况，有助于指导临床及时采取干预措施改善患者生活质量和预后。 |
| 英文摘要: |
| ABSTRACT Objective: To evaluate the frailty status of elderly patients with chronic heart failure (CHF) based on Tilburg frailty assessment scale, and to analyze the risk factors of frailty, and explore its impact on patients' quality of life and prognosis. Methods: 102 elderly patients with CHF who were admitted to our hospital from March 2020 to March 2022 were selected, and they were divided into frailty group and non-frailty group according to Tilburg Frailty assessment scale. The baseline data of patients were collected, and the quality of life of patients was evaluated by the Minnesota Living with Heart Failure Questionnaire (MLHFQ). Multivariate Logistic regression was used to analyze the risk factors of frailty in elderly patients with CHF. Spearman correlation analysis was used to analyze the correlation between the Tilburg frailty assessment scale score and MLHFQ score in the frailty group. The quality of life, 90 d unplanned readmission rate and mortality were compared between the two groups. Results: The incidence of frailty in 102 elderly patients with CHF was 53.92% (55/102). Multivariate Logistic regression analysis showed that: decreased body mass index (BMI), NYHA cardiac function class Ⅲ～Ⅳ, increased number of comorbidities, decreased hemoglobin (Hb), increased red blood cell distribution width (RDW), decreased albumin(Alb), and increased N-terminal pro-B-type brain natriuretic peptide (NT-probNP) were independent risk factors for frailty in elderly patients with CHF(P<0.05). The MLHFQ scores of physical domain, emotional domain and other domains in the frailty group were higher than those in the non-frailty group(P<0.05). Spearman correlation analysis showed that Tilburg frailty assessment scale scores in elderly patients with CHF with frailty were positively correlated with MLHFQ scores in physical domain, emotional domain and other domains (rs＝0.505, 0.424, 0.526, all P<0.001). After 90 days of follow-up, the unplanned readmission rate in the frailty group was higher than that in the non-frailty group(P<0.05). Conclusion: The incidence of frailty in elderly patients with CHF is high. BMI, NYHA cardiac function classification, number of comorbidities, Hb, RDW, Alb and NT-probNP are the influencing factors of frailty in elderly patients with CHF. Frailty can lead to the decline of quality of life and poor prognosis of patients. Tilburg frailty assessment scale can rapidly evaluate the frailty status of elderly patients with CHF, which is helpful to guide clinical interventions to improve the quality of life and prognosis of patients. |
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