| Objective: In this study,we evaluated the scale and collected case data from elderly patients with coronary heart disease combined with frailty or pre-frailty to investigate the factors influencing the progression from pre-frailty to frailty in elderly patients with coronary heart disease,measured the Traditional Chinese Medicine(TCM)constitution and quality of life(QOL)in this group,and explored the correlation between their TCM constitution and QOL.To provide new ideas for slowing down the progression of debilitation in elderly patients with coronary heart disease,improving their TCM constitution and enhancing their QOL.Material and method: The study has passed ethical review of the Ethics Committee of the Affiliated Hospital of Liaoning University of Chinese Medicine,and a cross-sectional study survey was used.Between January 2022 and January 2023,The subjects were inpatients from the second department of cardiology,the first department of cardiology and the geriatrics department of the Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,all of whom were elderly patients with coronary heart disease over 60 years old.They were divided into a pre-frailty group(102cases)and a frailty group(88 cases)by Fired criteria for frailty syndrome.Questionnaires were administered to the two groups of elderly patients with coronary artery disease in the form of one-to-one doctor-patient question and answer sessions,respectively,which included: general information,the TCM Physical Fitness Classification and Determination Form,and the Brief Health Status Questionnaire(SF-36).Clinical data collection was completed by asking patients’ medical history and collecting case information.The clinical data collection included: cardiovascular disease status,chronic disease status,and cardiovascular-related physical and chemical examinations.Factors influencing the progression from pre-frailty to frailty,TCM physical distribution and QOL were analyzed for the two included groups.The data summarized were analyzed using SPSS 26.0,with P<0.05 indicated a statistically significant difference and P<0.01 indicated conspicuous difference.Results:1.A total of 210 cases of old coronary heart disease patients were investigated,115 cases in the pre-frailty group and 95 cases in the frailty group,of which 12 cases were shed and 8 cases were excluded.Finally,190 cases were selected for this study,including 102 cases in the pre-frailty group and 88 cases in the frailty group.2.General data in residence,age,life partner,number of children,whether there was a spouse,number of procedures experienced,weekly activity time,and whether a pacemaker was implanted were statistically different between the pre-frailty group and the frailty group(P<0.05).History of percutaneous coronary intervention and gender were not statistically different between the pre-frailty group compared with the frailty group(P>0.05).3.Among chronic diseases,cerebrovascular diseases,renal system diseases,respiratory system diseases,and bone and joint diseases were statistically different between the pre-frailty group and frailty group(P<0.05).The prevalence of the above chronic diseases was higher in the frail group than in the pre-frailty group.There were no significant differences in diabetes and rheumatic diseases between the two groups(P >0.05).4.Hypertension,heart failure and atrial fibrillation among cardiovascular system diseases were statistically significantly different between the pre-frailty group and the frailty group(P<0.01).The prevalence of cardiovascular diseases in the frailty group was higher than that in the pre-frailty group.Among the arrhythmias,there was no statistically significant difference in incident atrial premature,incident ventricular premature,Intraventricular block,and sinus bradycardia between the pre-frailty group and the frailty group(P>0.05).5.Triglyceride,blood glucose,glycosylated hemoglobin and left ventricular ejection fraction(LVEF)in the pre-frailty group were higher than those in the frailty group,while uric acid and low density lipoprotein cholesterol were higher in the frailty group.There were statistically significant differences in LVEF between the pre-frailty group and the frailty group(P<0.01),but there were no significant differences in uric acid,blood glucose,triglyceride,low density lipoprotein cholesterol and glycosylated hemoglobin between the pre-frailty group and the frailty group(P>0.05).6.Logistic regression analysis of frailty showed that age(70-79 years old,OR=1.818,P>0.05;over 80 years old,OR=12.5,P<0.01),spouse(OR=0.244,P<0.01),number of surgeries(1,OR=1.040,P>0.05;2,OR=1.053,P>0.05;3 times or more,OR=6.875,P< 0.01),weekly activity time(11-20 hours,OR=0.385,P<0.01;21 hours or more,OR=0.644,P>0.05),residence(nursing home,OR=2.945,P>0.05;children’s family,OR=2.283,P<0.05),number of children(2,OR=1.733,P>0.05;3 or more,OR=2.69,P<0.01).Life partner(oneself,OR=1.692,P>0.05;children,OR=2.444,P<0.01 spouse and children,OR=2.397,P<0.01),bone and joint disease(OR=7.864,P<0.01),heart failure(OR=6.543,P<0.01),hypertension(OR=3.143,P<0.01),heart function level(level 2,OR=4.462,P<0.01;level 3,OR=7.436,P<0.01;level 4,OR=12.827,P<0.01),LVEF(OR=0.943,P<0.01).7.In the pre-frailty group,qi deficiency(30 cases,29.4%)and blood stasis(19 cases,18.6%)were the main constitution types.In the frailty group,30 cases(34.1%)of yang-qi deficiency and 28 cases(31.8%)of qi deficiency were the main constitution types.The constitution in the pre-frailty group and the frailty group was statistically tested χ2=15.929,P=0.027(P<0.05),and the difference was statistically significant.8.Logistic regression analysis of constitution type factors in debilitation showed that yang-qi deficiency was an independent risk factor for the progression of pre-frailty to debilitation among constitution type factors(OR=6.500,P<0.01).9.Dimensions of QOL between pre-frailty group and frailty group in elderly patients with coronary heart disease: There were differences in physiological function(PF),physical pain(BP),general health(GH),vitality(VT),social function(SF),mental health(MH),role-emotional(RE)and role-physical(RP)(P<0.01).Scores of the frailty group were worse than those of the pre-frailty group in all dimensions.10.The QOL of elderly patients with coronary heart disease differed among different constitution qualities,and the QOL of elderly patients with coronary heart disease of yang-qi deficiency was the worst.11.Spearman correlation analysis of QOL in elderly patients with coronary heart disease showed that QOL was highly negatively correlated with frailty(r=-0.818,P<0.01),moderately negatively correlated with yang-qi deficiency(r=-0.363,P<0.01),moderately negatively correlated with age(r=-0.457,P<0.01),and moderately negatively correlated with the number of surgeries(r=-0.457,P<0.01).(r=-0.165,P<0.05),moderate negative correlation with heart failure(r=-0.427,P<0.01),low negative correlation with pacemaker implantation(r=-0.159,P<0.05),low negative correlation with bone and joint disease(r=-0.253,P<0.01),low negative correlation with hypertension(r=-0.155,P<0.05).There was a low positive correlation with weekly activity time(r=0.196,P<0.01)and a low positive correlation with spouse(r=0.256,P<0.01).Conclusion:1.Elderly patients with pre-frailty coronary heart disease who are 80 years of age or older,have experienced 3 or more procedures,live in their children’s home,have 3 or more children,live with children,have a cardiac function level I or higher,and have bone and joint disease,heart failure,and hypertension are at higher risk of progression to frailty.Having a spouse,11-20 hours of activity per week,and high LVEF are protective factors for frailty progression in elderly patients with coronary heart disease.2.In elderly coronary heart disease patients with combined pre-frailty,qi deficiency and blood stasis are the main constitution type,and combined frailty,yang-qi deficiency and qi deficiency are the main constitution type.Yang-qi deficiency is an independent risk factor for the progression of pre-frailty to frailty among the constitution type factors.3.All dimensions of survival quality were worse in frailty elderly coronary heart disease patients than in pre-frailty elderly coronary heart disease patients,and there was a correlation between the QOL of elderly coronary heart disease patients and their TCM constitution. |
PDF Full Text Request