| Objective This study is aimed to invastigate the frailty condition of geriatric sufferers with pulmonary carcinoma,and explore the relationship between AGILE frailty assessment and the risk of falls and venous thromboembolism in elderly lung cancer patients,in order to provide novel thoughts for the prevention of advers caring accidents such as falls and VTE by adopting improved and effective targeted forward nursing initiatives,and to broaden the perspective for more in-depth studies in the future.Method A cross-sectional study was done in 215 aged inpatients with lung tumor.The AGILE scale,MFS and Caprini scale were utilized to evaluate the exposure to frailty,falls and VTE,respectively.Data were analyzed using SPSS26.0,and numerical data were converted to rates and proportions;mesurement data that fit normal distribution were reported as average ± standard deviation;those not conforming to normal were calculated as median and intra-quartile range(M(P25,P75)).Tests for conformity to normality were performed by Anova;Tests for non-conformity to normality were performed by rank sum test;qualitative data were analysed using Chi-square test,Fisher’s exact probability method and rank sum test,respectively.The Pairwise comparisons between multiple groups were analyzed using the bonferroni method.Spearman rank correlation was used to analyze the correlation between the influencing factors of frailty in elderly patients with lung cancer.Logistic regression and receiver operating characteristic curves were used to analyze the factors influencing the risk of frailty,fall and VTE,respectively.Logistic regression and receiver operating characteristic were used to calculate AUC,sensitivity,specificity and correctness index,and to determine AGILE score thresholds,and to evaluate the effect of AGILE score in predicting the risk of falls and VTE.Results:1.A total of 215 lung cancer patients,aged 61-79 years,122(56.74%)male and 93(43.26%)female were enrolled;the pathological type was mainly adenocarcinoma,accounting for 86.97%,followed by squamous cell carcinoma(11.63%);64.65%of the sick underwent surgery,and chemotheropy patients accounting for 35.35%.The occurrence of frailty in elderly lung cancer patients:153(71.16%)pre-frail patients and 24(11.16%)mildly frail patients.2.Analysis of the effectiveness of AGILE score in predicting fall risk:(1)Logistic regression analysis of AGILE score and fall risk classfication:with fall risk as the dependent variable(no risk=0,low risk=1),and AGILE score as the independent variable.For each 1-point increase in AGILE score in elderly lung cancer patients,the risk of falling assessed as low risk was 6.23 times higher than no risk(OR=6.23,95%CI:3.75-10.37,P<0.001).(2)The ROC curve analysis of AGILE score:the area under ROC curve was 0.84(0.78,0.91).when the threshold of AGILE score was 2,model sensitivity was 0.83,the specificity was 0.93,and the correctness index was 0.77.(3)Multivariate Logistic regression of fall risk and ROC curve were performed.The results showed that:AGILE score was an independent risk factor for fall risk(P=0.005),and the area of ROC curve was 0.63.3.Analysis of the effectiveness of AGILE score in predicting VTE risk:(1)Logistic regression analysis of AGILE score and VTE risk classfication:with VTE risk as the dependent variable(moretate risk=1,high risk=2),and AGILE score as the independent variable.For each 1-point increase in AGILE score in elderly lung cancer patients,the risk of VTE assessed as high risk was 24.82 times higher than medium risk(OR=24.82,95%CI:11.25-54.79,P<0.001).(2)The ROC curve analysis of AGILE score:the area under ROC curve was 0.92(0.88,0.96).when the threshold of AGILE score was 2,sensitivity of model was 0.87,the specificity was 0.94,and the correctness index was 0.81.(3)Multivariate Logistic regression of VTE risk and ROC curve were performed.The results showed that:AGILE score was an independent risk factor for VTE risk(P<0.001),and the area of ROC curve was 0.75.Conclusion:1.AGILE scale can quickly identify the frailty of patients in four dimentions:physical,psychological,social and economic support.The physical,psychological,and social functions of elderly lung cancer patients are siginificantly reduced with the long-term consumption of the disease,therefore the scale can quickly and effectively identify the frailty of elderly lung cancer patients from multiple dimentions in the busy nursing work.2.When AGILE score was greater than 2,it may have a good effect on predicting fall risk.It could be considered that fall risk was low risk,and it is recommended to combine fall risk assessment and take perfect and effective targeted preventive measures according to the frail status of patients.3.When AGILE score was greater than 2,it may have a good effect on predicting VTE risk.It could be considered that VTE risk was high risk,and it is recommended to combine VTE risk assessment and take perfect and effective targeted preventive measures according to the frail status of patients.4.The use of AGILE can screen patients at risk for falls or VTE,thereby reducing unnecessary multiple assessments and safely and effectively lightening nurse workload. |
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