Frail status and influencing factors in elderly inpatients with comorbidity
Received:September 10, 2018  Revised:October 09, 2018
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DOI:10.11915/j.issn.1671-5403.2019.01.002
Key words:aged; inpatients; comorbidity; frailty
Author NameAffiliationE-mail
ZHOU Li-Hua Department of Geriatrics,Chengdu 611130, China ;Institute of China-France Cooperation, the Fifth People′s Hospital of Chengdu, Chengdu 611130, China  
WANG Ling-Xiao Department of Geriatrics,Chengdu 611130, China ;Institute of China-France Cooperation, the Fifth People′s Hospital of Chengdu, Chengdu 611130, China  
YANG Yong-Xue Department of Geriatrics,Chengdu 611130, China ;Institute of China-France Cooperation, the Fifth People′s Hospital of Chengdu, Chengdu 611130, China  
GUAN Li-Juan Department of Geriatrics,Chengdu 611130, China ;Institute of China-France Cooperation, the Fifth People′s Hospital of Chengdu, Chengdu 611130, China  
DENG Ming-Hong Department of Geriatrics,Chengdu 611130, China ;Institute of China-France Cooperation, the Fifth People′s Hospital of Chengdu, Chengdu 611130, China  
SHEN Jing Department of Geriatrics,Chengdu 611130, China ;Institute of China-France Cooperation, the Fifth People′s Hospital of Chengdu, Chengdu 611130, China drshenjing@163.com 
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Abstract:
      Objective To clarify the distribution characteristics of frail status in elderly inpatients with comorbidity, and to further explore its influencing factors. Methods A cross-sectional survey was conducted among 440 inpatients with comorbidities over 60 years old in our department from November 2015 to July 2017. According to their status of frailty, they were divided into frailty group (n=150) and non-frailty group (n=290). The general demographic data, comorbidities, frailty status and senile syndrome were compared between the 2 groups. SPSS statistics 23.0 was used for statistical analysis. Independent sample t test, Mann-Whitney U test or Chi-square test was used to compare the difference between 2 groups. Mantel-Haenszel Chi-square test was employed to analyze the trend of frailty distribution. Risk factors were analyzed by backward stepwise binary logistic regression. Results Among the 440 elderly patients, they suffered from 5(4,7) kinds of chronic diseases on average, and the mean score of Charlson comorbidity index (CCI) was (5.59±1.82). The prevalence of frailty was 34.1%(150/440), and that of pre-frailty status was 60.0%(264/440). Trend test results showed that with older age and increased CCI score, the prevalence of frailty was increased significantly (P<0.05). Among the 5 factors of frailty, the incidence of weight loss was increased with older age and increased CCI score, while the incidences of grip decrease and fatigue were increased with older age (P<0.05). Compared with non-frailty group, the frailty group were older, lower educational level, and higher fall risk, and were more prone to having chronic heart failure, chronic obstructive pulmonary disease (COPD), depression, cognitive impairment, urinary incontinence, and functional dependence, but they had significantly lower proportion of polypharmacy (all P<0.05). After adjustment for confounding factors, binary logistic regression analysis showed that depression (OR=2.178, 95%CI 1.252-3.790) and functional dependence (OR=1.942,5%CI 1.029-3.668) were independentrisk factors for frailty. Conclusion Frailty is common in the elderly inpatients with comorbidities, and the prevalence of frailty tends to increase with oler age and severer comorbidities. Depression and functional dependence are closely related to the status of frailty.
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