Analysis Of Risk Factors In Elderly Patients With Heart Failure And Frailty

Objective Since China entered an aging society in 1999,according to relevant statistics,it is currently the country with the largest aging population in the world,and the elderly in my country account for 20% of the world’s elderly population.With the increase of population aging,the prevalence of frailty and heart failure has also increased.More and more studies have found that frailty and cardiovascular disease are closely related.The two have the same pathogenesis and worsen each other’s prognosis.By analyzing the correlation between frailty and chronic heart failure in the elderly,research its influencing factors and provide clinical evidence for its intervention.Methods From March 2019 to March 2020,236 elderly heart failure patients who were hospitalized in the Department of Geriatrics and Cardiology of our hospital and reached the discharge standard during the stable period were collected.All of them voluntarily participated in the study and signed the informed consent.Inclusion criteria:age ≥ 60 years;the diagnosis of heart failure refers to the 2018 China "Guidelines for the Diagnosis and Treatment of Chronic Heart Failure".Exclusion criteria: critically ill patients requiring first aid,advanced tumors,end-stage chronic diseases,severe dementia,severe arrhythmia,unable to communicate,refused or unable to receive evaluation.Collect the following clinical data for patients with heart failure included in the study,including: 1)General information [age,gender,cardiac function classification,comorbidities(chronic obstructive pulmonary disease,hypertension,diabetes,renal insufficiency,coronary heart disease,atrial fibrillation,Myocardial infarction,dilated cardiomyopathy,cerebral infarction)];2)laboratory data(total number of white blood cells,neutrophil ratio,lymphocyte ratio,red blood cells,hemoglobin,platelet count,albumin,total protein,blood uric acid,creatinine,urea Nitrogen,fasting blood glucose,total cholesterol,low-density lipoprotein,high-density lipoprotein,triglycerides,B-type natriuretic peptide,creatine kinase isoenzyme,creatine kinase,lactate dehydrogenase,myoglobin,D-Dimer,C-reactive protein);3)Cardiac ultrasound data(left ventricular ejection fraction,aortic inner diameter,left atrial inner diameter,left ventricular end-diastolic inner diameter,left ventricular end-systolic inner diameter,ventricular septal thickness,left ventricular posterior wall thickness).According to Fried frailty evaluation criteria,they were divided into frailty group and non frailty group.After single factor analysis of the above indicators,logistic regression analysis was used to explore the risk factors of elderly inpatients with heart failure and frailty.Results Among the 236 elderly patients with heart failure in this study,136 were in the frail group(57.63%,median age was 78 years),and 100 in the non-debilitated group(42.37%,median age was 74.5 years),male 127 cases(accounting for 53.81%)and 109 cases were female(accounting for 46.19%).Compared with the non-debilitating group,the difference was statistically significant in the following factors(P<0.05): age,cardiac function classification,when combined with renal insufficiency,when combined with dilated heart disease,hemoglobin,blood uric acid,creatinine,BNP,CRP,LVEF,aortic inner diameter,left ventricular end diastolic inner diameter,left ventricular end systolic inner diameter,ventricular septal thickness,left ventricular posterior wall thickness.Taking the above statistically different factors as independent variables and frailty as the dependent variable,Logistic regression analysis showed cardiac function classification(p=0.009),creatinine(p=0.045),LVEF(p=0.000),aortic diameter(p=0.004)The p values are all less than 0.05,and the difference is statistically significant.It can be considered that these four items are the fundamental influencing factors of heart failure combined with weakness.In summary,the prevalence of patients with heart failure combined with frailty is relatively high,and the classification of heart function,creatinine,LVEF,and aortic diameter are closely related to the combined frailty of elderly inpatients with heart failure.Conclusion Frailty is related to chronic heart failure.The prevalence of frailty is higher in patients with heart failure.Frailty is not unique to the elderly,and the concept of frailty should not be limited to geriatrics.Cardiac function classification,creatinine,left ventricular ejection fraction,and aortic diameter are risk factors for patients with heart failure and weakness.Based on this,patients with heart failure can be used to predict weakness and provide individualized treatment.