| 姚振宇,陈莉,范西真,等.高龄非瓣膜性心房颤动住院患者衰弱现状及其对预后的影响[J].中国临床保健杂志,2025,28(3):345-349. |
| 高龄非瓣膜性心房颤动住院患者衰弱现状及其对预后的影响 |
| The current status of frailty and its impact on prognosis in inpatients of advanced age with non-valvular atrial fibrillation |
| 投稿时间：2025-04-07 |
| DOI：10.3969/J.issn.1672-6790.2025.03.012 |
| 中文关键词: 非瓣膜性心房颤动 衰弱 危险因素 预后 老年人 |
| 英文关键词: Non-valvular atrial fibrillation Frailty Risk factors Prognosis Aged 〖FL |
| 基金项目:安徽省自然科学基金项目(2108085MH253) |
| 作者 | 单位 | E-mail | | 姚振宇 | 蚌埠医科大学研究生院,蚌埠 233030
中国科学技术大学附属第一医院安徽省立医院,老年医学科,合肥 230001 | 202500590@qq.com | | 陈莉 | 中国科学技术大学附属第一医院安徽省立医院,老年医学科,合肥 230001 | chenli7703@163.com | | 范西真 | 中国科学技术大学附属第一医院安徽省立医院,全科医学科 | | | 赵冰 | 中国科学技术大学附属第一医院安徽省立医院,老年医学科,合肥 230001 | | | 汤子秋 | 蚌埠医科大学研究生院,蚌埠 233030 | | | 刘玉林 | 蚌埠医科大学研究生院,蚌埠 233030 | |
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| 中文摘要: |
| 目的 调查衰弱在高龄(≥75岁)非瓣膜性心房颤动(NVAF)住院患者中的发生情况,并分析衰弱对高龄NVAF住院患者临床预后的影响。方法 回顾性分析2022年5月至2023年7月于中国科学技术大学附属第一医院(安徽省立医院)住院治疗的188例高龄(≥75岁)NVAF患者的临床资料。根据患者入院时的衰弱评分量表(Frail量表)评估衰弱状态分组(评分≥3分为衰弱组,评分＜3分为非衰弱组)。随访12个月,记录此期间血栓栓塞事件、出血事件、再入院及全因死亡的发生情况。采用Cox回归模型分析衰弱对高龄NVAF患者全因死亡的影响。结果 所有患者中衰弱的检出率达53.7%(101/188)。与非衰弱组相比,衰弱组患者的Charlson共病指数评分、累积疾病评分、CHA2DS2-VASc评分、Morse评分更高,Barthel评分更低,且衰弱组血红蛋白、白蛋白、估算的肾小球滤过率、左心室射血分数更低,而氨基末端B型利钠肽前体、血肌酐则更高。在预后方面,随访期间衰弱组血栓事件发生率和再入院率均显著高于非衰弱组(P＜0.05)。随访期间衰弱组死亡率(15.84%)显著高于非衰弱组(3.45%)。生存分析显示,衰弱与较差的生存情况相关。多因素Cox回归模型分析显示,衰弱是高龄NVAF患者全因死亡的独立危险因素(HR=4.46,95%CI:1.02～19.52,P＜0.05)。结论 高龄NVAF住院患者中衰弱的发生率较高,衰弱的高龄NVAF患者具有较高的血栓风险、再入院率及死亡率,且衰弱是其全因死亡的独立危险因素。 |
| 英文摘要: |
| Objective To investigate of the occurrence of frailty in hospitalized elderly patients aged 75 years and older with non-valvular atrial fibrillation (NVAF) and analysis of the impact of frailty on clinical outcomes in this population.Methods This retrospective study enrolled 188 elderly patients with non-valvular atrial fibrillation (NVAF) who were hospitalized at the First Affiliated Hospital of University of Science and Technology of China between May,2022,and July,2023.Frailty status was assessed using the Frail Scale at admission:patients scoring 3 or higher were assigned to the frailty group,while those scoring below 3 formed the non-frail group.Clinical data were collected and patients were followed up for 12 months to record thromboembolic events,bleeding events,hospital readmissions,and all-cause mortality.Cox regression models were used to evaluate the impact of frailty on all-cause mortality in elderly NVAF patients.Results In this study,the detection rate of frailty was 53.7% (101/188).Regarding baseline characteristics,compared with the non-frail group,the frailty group had higher Charlson Comorbidity Index scores,cumulative disease scores,CHA2DS2-VASc scores,and Morse scores,lower Barthel scores,as well as lower hemoglobin,albumin,estimated glomerular filtration rate,and left ventricular ejection fraction,but higher N-terminal pro Brain Natriuretic Peptide and creatinine levels.In terms of outcomes,the frailty group had significantly higher thromboembolic event rates and hospital readmission rates than the non-frail group during follow-up (P<0.05).Mortality was also higher in the frailty group (15.84% vs 3.45%).Survival analysis indicated that frailty was associated with worse survival outcomes.Multivariate Cox regression analysis showed that frailty was an independent risk factor for all-cause mortality in elderly NVAF inpatients (HR=4.46,95%CI:1.02-19.52,P<0.05).Conclusions The incidence of frailty is high among hospitalized elderly patients with NVAF.Frail elderly NVAF inpatients exhibit higher thromboembolic risk,hospital readmission rates,and mortality,with frailty serving as an independent risk factor for all-cause mortality. |
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