摘要
目的:探讨衰弱与老年Ⅰ型、Ⅱ型呼吸衰竭患者预后的关系及对死亡风险的预测价值。方法:回顾性分析224例因呼吸衰竭入住首都医科大学附属北京同仁医院呼吸与危重症医学科的老年患者的临床资料,根据衰弱量表评分将患者分为轻度衰弱组(衰弱量表评分≤5分)、中度衰弱组(衰弱量表评分为6分)和重度衰弱组(衰弱量表评分为7分)。对比老年Ⅰ型、Ⅱ型呼吸衰竭患者不同衰弱程度的临床资料,采用多元Logistic回归分析预后的危险因素,采用受试者工作特征(ROC)曲线下面积(AUC)分析衰弱量表评分联合其他指标对患者死亡风险的预测能力。结果:Ⅰ型呼吸衰竭入院的不同衰弱程度组老年患者的死亡率比较未见统计学差异(P>0.05);Ⅰ型呼吸衰竭入院的重度衰弱组老年患者的死亡率高于轻度衰弱组和中度衰弱组(P<0.05);多元Logistic回归分析结果显示:年龄、血乳酸、急性生理和慢性健康状况评分Ⅰ(APACHEⅡ)评分是影响老年Ⅰ型呼吸衰竭患者死亡的独立危险因素(P<0.05);衰弱量表评分、年龄、APACHE Ⅱ评分及血乳酸水平均为老年Ⅱ型呼吸衰竭患者死亡的独立危险因素(P0.05)。衰弱量表评分联合年龄、APACHE Ⅱ评分、血乳酸预测老年Ⅱ型呼吸衰竭患者死亡风险的AUC大于衰弱量表评分、年龄、APACHEⅡ评分、血乳酸单独预测。结论:衰弱与老年Ⅰ型呼吸衰竭患者预后无关,衰弱是老年Ⅱ型呼吸衰竭患者发生死亡事件的独立危险因素,对老年Ⅱ型呼吸衰竭进行衰弱量表评分可辅助评估患者预后。
Objective:To explore the relationship between frailty and the prognosis of elderly patients with typeⅠand type Ⅱ res-piratory failure and its predictive value for the risk of death.Methods:The clinical data of 224 elderly patients who were admitted to the Department of Respiratory and Critical Care Medicinee of Beijing Tongren Hospital Affliated to Capital Medical University due to respi-ratory failure were retrospectively analyzed.According to the score of the frailty scale,the patients were divided into mild frailty group(frailty scale score≤5 scores),moderate frailty group(frailty scale score was 6 scores)and severe frailty group(frailty scale score was 7 scores).The clinical data of different degrees of frailty in elderly patients with typeⅠand type Ⅱ respiratory failure were compared.The prognostic risk factors were analyzed by multiple Logistic regression.The receiver operating characteristic(ROC)area under curve(AUC)was used to analyze the prediction ability of frailty scale score combined with other indicators on the risk of death.Results:There was no significant difference in the mortality of elderly patients with hospitalized with typeⅠrespiratory failure at different degree of fraily(P>0.05).The mortality of elderly patients in severe frailty group with type Ⅱ respiratory failure was higher than that in mild fraity group and moderate frailty group(P<0.05).Multiple Logistic regression analysis showed that age,blood lactic acid,acute physiology and chronic health Ⅱ(APACHE Ⅱ)score were independent risk factors for death in elderly patients with typeⅠrespiratory failure(P<0.05).Fraity scale score,age,APACHE Ⅱ score and blood lactic acid level were independent risk factors for death in elderly patients with type Ⅱ respiratory failure(P<0.05).The AUC of frailty scale score jointed with age,APACHE Ⅱ score and blood lactic acid in predicting the risk of death in elderly patients with type Ⅱ respiratory failure was grecater than that of frailty scale score,age,APACHE Ⅱ score and blood lactic acid alone.Conclusion:Frailty is not associated with the prognosis of elderly patients with typeⅠrespiratory failure,and frailty is an independent risk factor for death events in elderly patients with type Ⅱ respiratory failure.Frailty scale score for elderly patients with type Ⅱ respiralory failure can assist in the evaluation of prognosis of patient.
作者
胥杰
姚秀娟
刘广杰
盛海燕
王新茂
庞剑
刘晓芳
XU Jie;YAO Xiu-juan;LIU Guang-jie;SHENG Hai-yan;WANG Xin-mao;PANG Jian;LIU Xiao-fang(Department of Respiratory and Critical Care Medicine,Beijing Tongren Hospital Affiliated to Capital Medical University,Beijing,100730,China)
出处
《现代生物医学进展》
CAS
2022年第9期1656-1661,共6页
Progress in Modern Biomedicine
基金
北京市自然科学基金项目(7212018)。
关键词
老年
衰弱
呼吸衰竭
死亡风险
预测价值
Elderly
Frailty
Respiratory failure
Risk of death
Predictive value
