| Objective:To evaluate the frailty status of elderly patients by observing 532 elderly inpatients in the Department of Geriatrics,Shandong Provincial Hospital of Traditional Chinese Medicine,and analyze the correlation between frailty status and TCM syndromes,number of comorbidities,nutritional status,blood lipids,and bone metabolism,and Further analyze the related risk factors of frailty,and provide guidance for intervening in the frailty state of elderly patients and delaying frailty.Methods:This project uses elderly patients(age≥60 years old)who were hospitalized in the Department of Geriatrics,Shandong Provincial Hospital of Traditional Chinese Medicine from December 2019 to June 2020 as the research object,and the Fried scale was used for frailty assessment when the patients were admitted to the hospital.Use the Jiahe electronic medical record system to count patients’ general information,TCM syndrome types,number of comorbidities,laboratory indicators(hemoglobin,total protein,albumin,prealbumin,triglycerides,total cholesterol,highdensity lipoprotein,low-density)Lipoprotein,osteocalcin,total type Ⅰcollagen amino acid extension peptide,β-collagen special sequence,vitamin D),establish a database,use SPSS26.0 statistical software for induction analysis,single factor analysis of count data using chi-square test,two The Bonferroni test was used for the two comparisons,the analysis of variance was used for the measurement data among multiple groups,the LSD test was used for the pairwise comparison,and the logistic regression analysis was used for the multivariate analysis.result:1.Distribution of frailty status:189 cases(35.5%)of 532 patients were frail,245 cases(46.1%)were pre-failed,and 98 cases(18.4%)were not frail(P<0.001).2.General data analysis(1)Gender:The proportions of women with frailty,pre-frailty,and no frailty were 32.8%;46%,and 21.2%,respectively,and the proportions of men with frailty,pre-frailty,and no frailty were 38.1%,46.1%,and 15.8%,respectively.There was no statistically significant difference in gender among different weak groups(P>0.05).(2)Age group:60～69 years old,the proportion of non-debilitating(67.6%)is higher than the pre-debilitating group(23.5%)and debilitating group(8.8%);70～79 years old,the proportion of pre-debilitating(69.6%)is higher than that of no debilitating Frailty(12.7%)and frailty group(17.7%),80～89 years old,frailty rate(51.5%)is higher than pre-frailty(45.4%)and no frailty group(3.0%),over 90 years old,frailty rate(88.7%))Was significantly higher than the pre-debilitating group(11.3%)and the non-debilitating group(0).The differences between different weak groups and pairwise comparisons were statistically significant(P<0.001).(3)Average age:The average age of the debilitating group(84.44±6.79)is higher than that of the pre-debilitating group(77.841±6.15);the average age of the pre-debilitating group is higher than that of the nondebilitating group(68.194±5.85).The differences between different weak groups and pairwise comparisons were statistically significant(P<0.001).3.TCM syndrome analysis:the proportion of patients in the weakened group with Qi deficiency and blood stasis syndrome,phlegm and blood stasis syndrome,and Qi and Yin deficiency syndromes(48.4%,43.7%,46.7%,respectively)is higher than that of the non-debilitated group and the pre-debilitated group;The proportion of patients in the pre-debilitating group with syndrome of deficiency of both kidneys,deficiency of both lungs and kidneys,deficiency of liver and kidney,deficiency of both qi and blood,and internal resistance of phlegm and dampness syndrome(59.6%,78.3%,65%,47.1%,57.1%,respectively)is higher than the non-debilitate.d group and the debilitated group;the proportions of the non-debilitated group and the pre-debilitated group(both 46.2%)of the Yin and Yang deficietncy are higher than the debilitated group(7.7%).The differences between different weak groups and pairwise comparisons were statistically significant(P<0.05).4.Analysis of the number of comorbidities:the proportion of nondebilitating comorbidities 1～5(58.6%)is higher than that of the predebilitating group(31.3%)and the debilitating group(10.1%),and the pre-debilitating ratio of 6～10(52.9%)is higher In the non-debilitated group(12.1%)and the debilitated group(35%),the proportion of debility≥11(53%)was higher than that in the non-debilitated group(3.9%)and the pre-debilitated group(43.1%).The differences between different weak groups and pairwise comparisons were statistically significant(P<0.001).5.Laboratory index analysis(1)There were statistical differences in hemoglobin and albumin in different weakened groups(P<0.05),but no statistical differences in total protein and prealbumin(P>0.05).Pairwise comparison found that the hemoglobin of the frailty group was lower than that of the non-frailty group and the pre-failure group(P<0.05),and the pre-frailty group was lower than the non-failure group,with no statistical difference(P>0.05);the frailty group had low albumin In the non-failure group and the prefailure group(P<0.05),the pre-failure group was lower than the nonfailure group(P<0.05).(2)There was no statistical difference in triglycerides,total cholesterol,low-density lipoprotein,and high-density lipoprotein among different frailty groups(P>0.05).(3)There were statistical differences in osteocalcin and vitamin D among different frailty groups(P<0.05),and there was no statistical difference in total type I collagen amino acid extension peptide and βcollagen special sequence(P>0.05).Pairwise comparison found that the osteocalcin of the frail group was lower than that of the non-frailty group and the pre-failure group(P<0.001),the pre-failure group was lower than the non-failure group(P<0.05);the vitamin D of the frailty group waslower than that of the non-failure group In the pre-debility group(P<0.001)and the pre-debility group(P<0.05),vitamin D in the pre-debility group was lower than that of the non-debility group(P<0.05).6.Multivariate logistic regression analysis:age(OR=4.057,95%CI:2.845-5.784),number of comorbidities(OR=1.258,95%CI:1.157-1.367),osteocalcin(OR=1.126,95%CI:1.084-1.170)are risk factors for old age frailty(P<0.001).in conclusion:1.Frailty is a common syndrome in elderly hospitalized patients.2.Old age frailty has nothing to do with gender,but is related to age.The older the age,the higher the incidence of frailty.3.Senile frailty is related to TCM syndromes,and the syndromes of Qi deficiency and blood stasis,phlegm and blood stasis,and Qi and Yin deficiency are more common.4.Old age frailty is positively correlated with the number of comorbidities.As the number of comorbidities increases,the degree of frailty increases.5.Aged frailty is related to hemoglobin and albumin.The hemoglobin and albumin of the frailty group are lower than those of the non-frailty and pre-failure group.6.Elderly frailty is related to osteocalcin and vitamin D.The osteocalcin and vitamin D of the frailty group are lower than those of the non-frailty and pre-failure group,and the osteocalcin and vitamin D of the pre-frailty group are lower than those of the non frailty group.7.Old age,coexistence of multiple diseases,and decreased osteocalcin are risk factors for old age frailty. |
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