The Investigation Of Preoperative Frailty Status And Development Of Prediction Model For Elderly Patients Undergoing Urological Surgery

Objective: To clarify the status and influencing factors of frailty in elderly urological patients before surgery,and build a frailty risk prediction model,so as to provide reference for nurses to identify high-risk groups of frailty in early stage and carry out targeted prevention.Methods: In this cross-sectional study,a total of 252 elderly patients who underwent urological surgery in a Third-class hospital from October 2021 to September 2022 were selected by convenience sampling.General information questionnaire,The FRAIL Scale,Charlson Comorbidity Index,ADL,GDS-15 and MNA-SF are used as research tools to collect patient-related data.Statistical analysis was performed using SPSS26.0 software.The unique risk factors are identified by binary logistic regression and a risk prediction model is established.ROC curve analysis was carried out to judge the diagnostic efficiency of the model.The goodness of fit of the model was evaluated using the H-L test.In this study,P<0.05 was considered to be statistically significant.Results: A total of 252 patients were included in this study,105 of which were frailty,and the incidence of frailty was 41.7%.1.Univariate analysis shows that: There were significant differences between frailty and non-frailty groups in age,marital status,residence status,main caregivers,pre-hospital exercise,BMI,degree of concern for social life,comorbidity,ADL,unhappiness,apathy and anxiety,memory loss and reduced social activities,loss of hope,and nutritional status(P < 0.05).2.Multivariate analysis showed that age,comorbidity,memory loss and social activities reduced,apathy and anxiety,and malnutrition were independent risk factors for frailty(P < 0.05).3.Based on the above five independent risk factors,a prediction model of preoperative frailty risk in elderly urological patients was established: P=1/1+exp(Z)=1/1+exp[-15.017+2.538× age(0,1,2)+1.987×CCI score +1.583× apathy and anxiety score +1.319×memory loss and social activity reduced score + 1.417×nutritional status score(0,1,2)].H-L test showed that the model had a good fit(χ2=6.662,P=0.573).4.ROC curve analysis results showed that the AUC was 0.859(95%CI:0.809～0.908,P<0.001).That indicating the model has a good diagnostic ability.Conclusions: The incidence of preoperative frailty in elderly urological patients is high.Age,comorbidity,memory loss and social activities reduced,apathy and anxiety,and malnutrition are independent risk factors for preoperative frailty in elderly urological patients.The established model for predicting the risk of frailty has good goodness of fit and diagnostic efficacy,which can provide reference for accurately predicting the frailty in elderly urological patients before surgery.