基于照护者的老年综合评估的衰弱指数与老年冠心病病人非计划再入院的相关性研究

doi:10.3969/j.issn.1003-9198.2025.08.012

摘要/Abstract

摘要： 目的探讨基于照护者的老年综合评估的衰弱指数(CP-FI-CGA)与老年CHD病人非计划再入院(unplanned readmission, UR)的相关性。方法选取2021年1月至2023年6月期间南京鼓楼医院老年科UR的200例CHD病人为研究对象。应用自行设计的问卷收集一般资料,应用CP-FI-CGA进行衰弱评估,并据此将研究对象分为非衰弱组(NF组)、衰弱前期组(PF组)和衰弱组(F组)。对病人进行前瞻性随访,终点事件为任何原因导致的UR。结果 200例病人中,39例(19.5%)病人为衰弱,62例(31.0%)病人为衰弱前期,99例(49.5%)病人为非衰弱状态。F组、PF组和NF组分别有22例、17例和20例发生UR,Kaplan-Meier曲线表明,3组无UR中位生存时间分别为2.9(2.0,4.0)个月、4.0(2.4,4.7)个月和4.0(3.0,4.6)个月,6个月无UR生存率分别为43.6%、72.6%和79.8%。3组间无UR的生存曲线差异具有统计学意义(χ²=25.213,P<0.001),F组无UR生存率明显低于NF组和PF组(均P<0.05)。多因素Cox回归分析显示,衰弱是影响老年CHD病人UR的独立危险因素。结论基于CP-FI-CGA评估的衰弱是影响老年CHD病人UR的独立危险因素,这为筛选再入院高危病人、制定针对性的干预措施提供了依据。

关键词: 冠心病, 老年人, 非计划再入院, 老年综合评估, 衰弱指数

Abstract: Objective To explore the association of care partner-frailty index-comprehensive geriatric assessment (CP-FI-CGA)and unplanned readmission (UR) in the elderly patients with coronary heart disease (CHD). Methods A total of 200 elderly CHD patients admitted to Department of Geriatrics, Nanjing Drum Tower Hospital without planned admission from January 2021 to June 2023 were enrolled. A self-designed questionnaire was used to collect the general information. CP-FI-CGA was used for frailty assessment, and the study subjects were divided into non-frailty group (NF group), pre-frailty group (PF group) and frailty group (F group) based on CP-FI-CGA. All patients were prospectively followed up, and the end event was defined as UR due to any reason. Results Among the 200 patients,39 patients (19.5%) showed frailty, 62 patients (31.0%) showed pre-frailty, and 99 patients (49.5%) showed non-frailty. There were 22 cases, 17 cases, and 20 cases of UR in F group, PF group and NF group, respectively. Kaplan-Meier curves revealed median UR-free survival times of 2.9 (2.0-4.0) months, 4.0 (2.4-4.7) months, and 4.0 (3.0-4.6) months in F group, PF group, and NF group, respectively. The 6-month UR-free survival rate was 43.6%, 72.6% and 79.8%, respectively. There was a statistically significant difference in the UR-free survival curves among the three groups (χ²=25.213, P<0.001). Multivariate Cox regression analysis showed that frailty was an independent risk factor for UR. Conclusions Frailty assessed by CP-FI-CGA is an independent risk factor for UR in the elderly patients with CHD, which provides a basis for screening high-risk individuals and developing targeted intervention.

Key words: coronary heart disease, aged, unplanned readmission, comprehensive geriatric assessment, frailty index

中图分类号:

R541.4

吴虹, 钱蕾, 达婧, 李伏超, 朱欢欢. 基于照护者的老年综合评估的衰弱指数与老年冠心病病人非计划再入院的相关性研究[J]. 实用老年医学, 2025, 39(8): 813-817.

WU Hong, QIAN Lei, DA Jing, LI Fuchao, ZHU Huanhuan. Association of care partner-frailty index-comprehensive geriatric assessment and unplanned readmission in elderly patients with coronary heart disease[J]. Practical Geriatrics, 2025, 39(8): 813-817.

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