关键词: 老年人, 骨关节炎, 衰弱, 危险因素, 风险评估模型, 列线图, 护理

Abstract:

Objective To analyze the influencing factors of frailty in elderly patients with lower extremity osteoarthritis，and to construct and validate the risk assessment model. Methods Convenient sampling method was used to select 535 elderly patients with lower extremity osteoarthritis from tertiary hospitals and community health service centers in Hangzhou from January to September 2022 as the survey subjects including 357 in the modeling group and 178 in the validation group. Univariate and multivariate logistic regression analysis were used to determine the risk factors of frailty，construct a risk assessment model and draw a nomogram. The discrimination and calibration of the model were evaluated by the area under the receiver operating characteristic curve and the Hosmer-Lemeshow test. The Bootstrap method was used for internal validation of the model，and the time verification method was used for external validation. Results The model variables included the number of affected joints，age-adjusted Charlson comorbidity index，pain，nutritional status，sedentary time，activity of daily living，osteoarthritis index，lower limb muscle strength，and Social Support Rating Scale score. The Hosmer-Lemeshow test results of the model showed that P=0.202，the area under the receiver operating characteristic curve was 0.942，the optimal critical value was 0.392，the sensitivity was 0.914，the specificity was 0.893，and the accuracy rate was 0.902. The internal and external validation showed that the C-statistics were 0.935 and 0.919，respectively，and the calibration curve showed good fitting. Conclusion The risk assessment model has a good degree of discrimination and calibration，which can more intuitively and easily screen elderly patients with lower extremity osteoarthritis at high risk of frailty，and provide references for early monitoring，identification，prevention and control.

Key words: Aged, Osteoarthritis, Frailty, Risk Factors, Risk Assessment Model, Nomogram, Nursing Care