Abstract:

Objective To explore the trajectory and influencing factors of frailty in liver transplant recipients，in order to provide evidence for clinical management of frailty in this population. Methods With the method for convenience sampling，210 patients who listed on the transplant waiting list in the liver transplantation department of a tertiary hospital in Qingdao from October 2021 to January 2023 were selected. The data of patients were collected by the general information questionnaire，the Liver Frailty Index Scale，the International Physical Activity Questionnaire，the Mini Nutritional Assessment Scale，the Perceived Social Support Scale，the Pittsburgh Sleep Quality Index Scale，the Hospital Anxiety and Depression Scale，and the Resilience Scale，by combining with the latent category growth model，to identify the frailty trajectory category，and to analyze its factors. Results 201 valid questionnaires were collected, with a valid questionnaire recovery rate of 95.53%. The LFI scores of T1-T6 patients were（7.39±1.53），（9.27±2.80），（9.52±2.88），（6.96±2.10），（4.98±1.37），（3.17±1.31）. 2 distinct trajectories were identified，including “low level-slow decline group”（68.16%） and “high level-rapid decline group”（31.84%）. Binary logistic regression analysis showed that age，primary disease，diabetes，polypharmacy，number of postoperative complications，nutritional status T1，sleep quality T2，physical activity T3，and anxiety T4 were the influencing factors of frailty trajectory in liver transplant recipients（P<0.05）. Conclusion The trajectory of frailty in liver transplant recipients showed significant group heterogeneity. Healthcare providers should prioritize frailty assessment in patients with advanced age，diabetes，multiple comorbidities，poor nutritional status，impaired sleep quality，low physical activity levels，and high anxiety，and implement targeted frailty interventions for these individuals.

Key words: Liver Transplantation, Frailty, Root Cause Analysis, Latent Class Growth Model, Nursing Care

摘要：

目的 探究肝移植患者衰弱变化轨迹及影响因素，为开展肝移植患者衰弱管理提供依据。 方法 采用便利抽样法，选取2021年10月—2023年1月在青岛市某三级甲等医院肝移植科的210例肝移植患者为调查对象，采用一般资料调查表、肝脏衰弱指数、国际体力活动问卷、微型营养评定量表简表、领悟社会支持量表、匹兹堡睡眠质量指数、医院焦虑抑郁量表、心理弹性量表收集患者资料，结合潜类别增长模型识别衰弱变化轨迹类别并分析其影响因素。 结果 回收有效问卷201份，有效问卷回收率为95.53%。T1~T6衰弱得分分别为（7.39±1.53）（9.27±2.80）（9.52±2.88）（6.96±2.10）（4.98±1.37）（3.17±1.31）分，识别出低水平缓慢下降组（68.16%）和高水平快速下降组（31.84%）2条衰弱变化轨迹。Logistic回归分析显示，年龄、原发病、糖尿病、多重用药、术后并发症数量、术前1周的营养状况、术后第2周的睡眠质量、术后1个月的躯体活动、术后3个月的焦虑水平是肝移植患者衰弱变化轨迹的影响因素（P<0.05）。 结论 肝移植患者衰弱变化轨迹呈现显著群体异质性，护士应重视年龄较大、合并糖尿病、并发症多、营养状况差、睡眠质量差、躯体活动少、焦虑水平高的患者的衰弱评估，并给予针对性的衰弱干预措施。

关键词: 肝移植, 衰弱, 影响因素分析, 潜类别增长模型, 护理