Analysis Of The Frailty Status And Its Risk Factors Of Elderly Patients In A Third-class Hospital Of The Corps

Objective: Analyze the frailty status and its risk factors of elderly patients in a third-class hospital of the corps,and provide references for preventing the occurrence of frailty and delaying the progress of frailty.Methods: 335 patients who were hospitalized in the Department of Geriatrics of the First Affiliated Hospital of Shihezi University School of Medicine from November 2019 to July 2020 and were aged ≥65years old were selected.Use the Fried frailty phenotype to assess frailty status,and a face-to-face questionnaire survey was conducted.The survey tools included assessment of activities of daily living(ADL),mini-mental state examination(MMSE),short form mini nutritional assessment(MNA-SF),and risk of falling/falling from bed in the field.Collect the patient’s general information,neutrophil/lymphocyte ratio(NLR),platelet/lymphocyte ratio(PLR),coagulation indicators,biochemical indicators,echocardiographic results,chronic disease conditions,etc.Divided into non-frailty group,pre-frailty group and frailty group according to the frailty status.The risk factors of frailty hospitalized elderly patients were analyzed by using single factor and multiple factors.P<0.05 means the difference is statistically significant.Results: 1.Basic information: Among the 335 hospitalized elderly patients,there are 164 males(49.0%)and 171 females(51.0%);the age is 65～91 years old,with an average age of 76.81±6.30 years old.Among them,122 patients(36.4%)were 65～74 years old,179 patients(53.4%)were 75～84 years old,and 34patients(10.2%)were 85 years old or older;The top 3 with chronic diseases were coronary heart disease(65.4%),cerebrovascular disease(63.9%),and hypertension(49.3%).2.Distribution characteristics of frailty: The prevalence of frailty in 335 hospitalized elderly patients was32.8%.The included patients were divided into 65～74 years old group,75～84 years old group,and ≥85years old group according to their age.The prevalence of frailty was 19.7%,36.9%,and 58.8%,respectively.The prevalence of frailty is increasing with age.The included patients were divided into ≤3chronic disease groups and >3 chronic disease groups according to the median number of chronic diseases.The prevalence of frailty was 24.4% and 40.9%,respectively.The prevalence of frailty in >3 chronic disease groups is higher than that in ≤3 chronic disease groups(P<0.05).3.Single factor analysis of risk factors for frailty in hospitalized elderly patients:(1)Comparison of general data of non-frailty group,pre-frailty group and frailty group: There are differences among the three groups in age,education level,hospitalization expenses,and hospitalization days(P<0.05).(2)Comparison of laboratory indicators: There are differences among the three groups in NLR,albumin(ALB),D-dimer,prothrombin activity(PTA)(P<0.05).(3)Comparison of echocardiography: There are differences among the three groups in left atrial diameter.(4)Comparison of chronic diseases: With coronary heart disease,cerebrovascular disease,hypertension,chronic renal insufficiency,chronic heart failure,and the number of chronic diseases there are differences among the three groups(P<0.05).(5)There are differences among the three groups in ADL,cognitive function,and nutritional status.4.Multi-factor analysis of risk factors for frailty in hospitalized elderly patients: NLR(OR=1.259,95%CI1.029～1.541),D-dimer(OR=1.714,95%CI 1.162～2.528),hypertension(OR=1.971,95%CI 1.161～3.348),chronic heart failure(OR=3.165,95%CI 1.037～9.658),impaired ADL(OR=3.004,95%CI 1.661～5.434),malnutrition(OR=3.992,95%CI 1.892～8.422)are the risk factors for frailty hospitalized elderly patients(P<0.05).Conclusion: 1.The prevalence of frailty elderly patients in a third-class hospital of the corps is higher.With the increase of age,the prevalence of frailty is on the rise.2.The frailty of hospitalized elderly patients is related to NLR,D-dimer,ALB,hypertension,chronic heart failure,ADL,and nutritional status.The higher the NLR level,the higher the D-dimer level,the patients with hypertension,chronic heart failure,ADL damage,and malnutrition are more likely to become frailty.The new inflammatory factor NLR provides a new reference index for clinicians in assessing of frailty in hospitalized elderly patients.