Abstract:

Objective To evaluate the frailty status and risk factors among hospitalized elderly patients after percutaneous coronary intervention（PCI），and to provide a reference for improving and delaying their frailty. Methods From March to August 2024，using convenience sampling，patients aged over 75 years who underwent PCI in a tertiary cardiovascular disease specialist hospital in Beijing were selected as the survey participants. Patient-related informations were collected through a self-designed general information questionnaire. The Fried Phenotype Frailty Scale，the Katz Activities of Daily Living，Lawton Instrumental Activities of Daily Living（IADL） scale，the Charlson Comorbidity Index，the Morse Fall Scale，the Mini Nutritional Assessment-Short Form（MNA-SF），and the 15-item Geriatric Depression Scale（GDS-15） were evaluated postoperatively until discharge. Univariate and multivariate logistic analyses were conducted to identify factors associated with frailty among patients after PCI. Results A total of 278 patients were included. The incidence of frailty after PCI was 52.16%. Based on Fried Phenotype scores，patients were divided into a non-frail group and a frail group. Univariate analysis showed statistically significant differences between the 2 groups in terms of age，gender，hemoglobin，NT-ProBNP，LVEF，IADL scores，living alone status，nutrition status，falls risk，and depression level（P<0.05）. Multivariate logistic regression analysis revealed that age，Lawton IADL scores，falls risk，nutrition status，depression level were factors influencing frailty，with odds ratios of 1.167，0.575，1.597，0.399，and 3.610，respectively（P<0.05）. Conclusion The incidence of frailty is high among patients aged over 75 years after PCI，and there are multiple risk factors affecting their frailty status. Clinical healthcare providers should prioritize long-term management of these patients and implement comprehensive interventions with the consideration of their physiological，psychological，and social conditions.

Key words: Aged, Coronary Heart Disease, Percutaneous Coronary Intervention, Frailty, Root Cause Analysis, Nursing Care

摘要：

目的 评估75岁以上行经皮冠状动脉介入治疗（percutaneous coronary intervention，PCI）术后患者的衰弱现状及危险因素，为改善、延缓其衰弱状态提供参考。方法 于2024年3月—8月，采用便利抽样法，选取北京市某三级甲等心血管病专科医院行PCI治疗的75岁以上患者作为调查对象，采用自行设计的一般资料调查表收集患者相关信息，于术后至出院前分别使用Fried衰弱表型、katz指数、工具性日常生活活动能力量表、Charlson共病指数、Morse跌倒评估量表、微型营养评定简表、简版老年抑郁量表进行综合评估。采用单因素及多因素Logistic回归分析PCI术后患者合并衰弱的影响因素。结果 最终纳入患者278例，PCI术后衰弱发生率为52.16%，按照Fried衰弱表型评分分为非衰弱组和衰弱组，单因素分析显示，两组年龄、性别、血红蛋白、N末端脑钠肽前体、左心室射血分数、工具性日常生活活动能力量表得分、是否独居、营养状况、跌倒风险、抑郁程度等方面的比较，差异具有统计学意义（均P<0.05）。多因素Logistic回归分析显示，年龄、工具性日常生活活动能力量表得分、跌倒风险、营养状况、抑郁程度是衰弱的影响因素，OR值分别为1.167、0.575、1.597、0.399、3.610（均P<0.05）。结论 75岁以上PCI术后患者衰弱发生率较高，其影响因素较多，临床医护人员要重视对这类患者的长期管理，结合老年人生理、心理及社会情况等进行综合干预。

关键词: 老年人, 冠心病, 经皮冠状动脉介入治疗, 衰弱, 影响因素分析, 护理