中华护理杂志 ›› 2022, Vol. 57 ›› Issue (15): 1859-1867.DOI: 10.3761/j.issn.0254-1769.2022.15.010
收稿日期:
2021-10-19
出版日期:
2022-08-10
发布日期:
2022-08-11
通讯作者:
高欢玲,E-mail: 1723212444@qq.com作者简介:
宋歌:女,本科(硕士在读),护士,E-mail: 827883181@qq.com
基金资助:
SONG Ge(), WANG Ying, GAO Huanling(), QIAO Meirong, CHEN Ling, YANG Yulin
Received:
2021-10-19
Online:
2022-08-10
Published:
2022-08-11
摘要:
目的 调查老年慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)患者认知衰弱的现状,分析相关影响因素并构建风险筛查模型。 方法 便利选取2020年5月—2021年3月山西省某三级甲等医院呼吸内科、老年科收治的386例老年COPD患者作为训练集,根据是否发生认知衰弱分为认知衰弱组(n=123)和非认知衰弱组(n=263)。通过单因素分析和Logistic回归分析筛选老年COPD患者认知衰弱的影响因素,构建风险筛查模型。于2021年4月—7月选取同一所医院住院的158例老年COPD患者作为验证集,对模型进行外部验证。 结果 训练集认知衰弱发生率为31.9%,验证集为35.4%。年龄、是否每天进行智力活动、是否多病共存、病程、肺功能分级、PaCO2是老年COPD患者认知衰弱的影响因素。风险筛查模型内部验证中,Hosmer-Lemeshow χ2检验P=0.328,受试者操作特征曲线下面积为0.813,约登指数为0.481,灵敏度为0.764,特异度为0.703。外部验证中,Hosmer-Lemeshow χ2检验P=0.468,受试者操作特征曲线下面积为0.886,灵敏度为0.732,特异度为0.824。 结论 老年COPD患者认知衰弱发生率较高,年龄≥70岁、未每天进行智力活动、多病共存、病程≥5年、肺功能分级>Ⅰ级、PaCO2>50 mmHg(1 mmHg=0.133 kPa)的老年COPD患者发生认知衰弱的风险较高。该文构建的风险筛查模型具有良好的区分度和校准度,可为临床医护人员评估老年COPD患者认知衰弱的发生风险、制订护理对策提供参考。
宋歌, 王颖, 高欢玲, 乔美荣, 陈玲, 杨玉霖. 老年慢性阻塞性肺疾病患者认知衰弱风险筛查模型的构建及验证[J]. 中华护理杂志, 2022, 57(15): 1859-1867.
SONG Ge, WANG Ying, GAO Huanling, QIAO Meirong, CHEN Ling, YANG Yulin. Construction and validation of a risk screening model for cognitive frailty in elderly patients with chronic obstructive pulmonary disease[J]. Chinese Journal of Nursing, 2022, 57(15): 1859-1867.
表1 训练集中老年慢性阻塞性肺疾病患者的一般资料及认知衰弱的单因素分析[例(百分比,%)]
Table 1 General information and univariate analysis of the risk of cognitive frailty in elderly patients with chronic obstructive pulmonary disease in the modeling set[cases(percentage,%)]
表2 老年慢性阻塞性肺疾病患者认知衰弱Logistic回归分析
Table 2 Logistic regression analysis of cognitive frailty in elderly patients with chronic obstructive pulmonary disease
图1 老年慢性阻塞性肺疾病患者认知衰弱风险列线图 注:1 mmHg=0.133 kPa。
Figure 1 Nomogram of risk of cognitive frailty in elderly patients with chronic obstructive pulmonary disease
图2 训练集中老年慢性阻塞性肺疾病患者风险筛查模型的受试者操作特征曲线
Figure 2 Receiver operator characteristic curve in elderly patients with chronic obstructive pulmonary disease of the modeling set
图3 验证集中老年慢性阻塞性肺疾病患者风险筛查模型的受试者操作特征曲线
Figure 3 Receiver operator characteristic curve in elderly patients with chronic obstructive pulmonary disease of the validation set
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