| Objective To evaluate the relationship between frailty and prognosis of elderly patients with coronary heart disease.Objective to analyze the frailty influencing factors of elderly patients with coronary heart disease.Based on the analysis of frailty influencing factors,a nomogram model was established to predict the risk of frailty in elderly patients with coronary heart disease,and the predictive efficiency of the model was further verified.Methods1.Computer search Pub Med,EMBASE,web of science,CINAHL,Cochrane Library,Chinese Journal Full-text Database,Chinese biomedical literature database,VIP,Wanfang database,and collect domestic and foreign literatures about the relationship between frailty and prognosis of patients with coronary heart disease.Use Revman 5.3 software for meta analysis.2.892 elderly patients with coronary heart disease who were hospitalized in the Department of Cardiology of a third class a hospital in Zhenjiang City from October 2019 to November2020 were selected as the research objects.The subjects were divided into modeling group and validation group according to the ratio of 1:1.The survey tools included general information questionnaire,coronary heart disease specific index scale,Barthel index scale,mini nutritional assessment scale,Chinese version of self rating Anxiety Scale and Chinese version of self rating depression scale.Firstly,the risk factors of frailty among elderly patients with coronary heart disease in the modeling group were analyzed by univariate analysis,and the statistically significant factors were further analyzed by multivariate logistic regression.R software was used to construct the frailty risk nomogram model of elderly patients with coronary heart disease.ROC curve was used to verify the prediction efficiency of the model.Results1.System evaluation results Finally,20 studies were included,with 14474 patients.The risk of death,recurrent myocardial infarction,readmission,massive hemorrhage and stroke / TIA in the frailty group was higher than that in the non frailty group(P < 0.05);There was no significant relationship between the frailty and the revascularization(P > 0.05).2.Univariate analysis In this study,a total of 446 patients were included in the modeling group.There were 151 cases(33.86%)in frail group and 295 cases(66.14%)in non asthenia group.Univariate analysis showed that,There was no significant difference in gender,smoking history,multiple medication,triple vessel disease,hypertension and tumor between the two groups(P > 0.05);There was a significant difference in age,living style,diabetes mellitus,lung disease,cerebrovascular disease,white blood cell count,hemoglobin,serum creatinine,fibrinogen,brain natriuretic peptide,left ventricular ejection fraction,coronary heart disease Specific index,NYHA heart function,activities of daily living,nutritional status,anxiety and depression between the two groups(P < 0.05).3.Logistic regression The results of multivariate analysis showed that age,coronary heart disease specific index,activities of daily living,cardiac function and nutritional status were independent risk factors of frailty among elderly patients with coronary heart disease.4.Model validation Internal verification results showed that AUC value of area under ROC curve was 0.885(P < 0.05),specificity was 83.7%,sensitivity was 86.1%;External validation results showed that AUC value of area under ROC curve was 0.859(P <0.05),specificity was 81.6%,and sensitivity was 88.5%.Conclusion 1.Frailty is closely related to the prognosis of patients with coronary heart disease.Medical staff should pay attention to the screening of patients’ frailty and early intervention,so as to improve the prognosis of patients.2.Age,coronary heart disease specific index,activities of daily living,cardiac function and nutritional status were the independent risk factors of frailty among elderly patients with coronary heart disease. |
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