| Objective:The elderly is increasingly concerned by the community,because of the particularity that the elderly is a vulnerable and high-risk group.Frailty is a common disease in the elderly.A series of negative clinical events can be caused by the frail elder who experience little external stimulation.The prevalence of frailty varies with different methods of assessment,but the general trend is that the prevalence increases with age.Similarly,heart failure is a common disease among the elderly,with nearly 80%of heart failure patients are older than 65 years old,and the prevalence of heart failure increases with age.Based on the world is gradually entering an aging society,and the existing studies have confirmed that there is an interaction between frailty and heart failure,the frailty risk of patients with heart failure increases by 6 times,the risk of new heart failure of frailty patients is also significantly increased,which together can lead to the deterioration of the health status of the elderly population.Therefore this study collected general data and related laboratory index in elderly inpatients with heart failure,analysis the correlation between the above factors and frailty,for helping assess the risk of frailty in elderly inpatients with heart failure,and it provides the basis for taking effective and targeted preventive measures in early clinical stage.Methods:The enrolled participants were 205 hospitalized elderly patients with heart failure who received treatment in Geriatrics Department and Cardiovascular Department,Chengde Central Hospital from September 2017 to October 2018.Making questionnaire,including age,sex,marriage,educational level,laboratory examination results,LVEF,establish a database.Within 24 hours of admission,Fried criteria were used to evaluate the degree of senile heart failure.All 205 eligible patients were divided into frail group and non-frail group according to whether they had frailty or not.Then 108 patients with frail were divided into HFrEF group,HFmrEF group,HFpEF group according to LVEF.Survey date after finishing the effective date obtained using the software of SPSS 22.0 statistical description,the measurement date were expressed in((?)±s),and differences between the groups were compared by t-test,multiple comparisons were performed by one-way ANOVA.The counting date were expressed by rate,and the differences between groups were compared by chi-square test.Logistic regression analysis was used to analyze the risk factors of frailty in elderly inpatients with heart failure.All date were analyzed with a statistical difference(P<0.05).Results:1.General information(data):The average age of 205 hospitalized elderly heart failure patients were 76.56±7.89 years.Among them,97(47.3%)were males and 108(52.7%)were females.There were 108(52.7%)patients in frail group and 97(47.3%)patients in non-frail group.64(59.3%)women in the frail group.The average age of the frail group and the non-frail group were 79.04±7.26 years vs 74.08±8.52 years.BMI of the frail group and the non-frail group were 22.44±3.18kg/m2 vs 24.61 ±3.68kg/m2.Two groups of patients were compared,there were no statistical difference in sex,smoking history,drinking history,operation history,living condition(P>0.05);there were statistical difference in age,the length of hospital stay,marriage,educational level,the history of falls in the past year and BMI(P<0.05).2.Comparison of detection rate of frailty in elderly inpatients with heart failure in different age groups:Among 45 patients aged 60 to 69,12(26.7%)were frail;among 75 patients aged 70 to 79,41(54.6%)were frail;Of 85 case of patients over the age of 80,55(64.7%)patients were frail.The detection rate of frailty in senile heart failure in hospitalized patients increased with age.3.Comparison of laboratory indicators between frail group and non-frail group:There were statistical difference in BNP,Hb,RBC,Ne,HDL-C and AL B(P<0.05).There were no statistical difference in WBC,TC,TG,LDL-C and TP(P>0.05).4.Multiple factor Logistic regression analysis of frailty in elderly in patients with heart failure:there were no significant difference in Hb,R BC,Ne,HDL-C,ALB,BMI,educational level and marriage(P<0.05);but there were significant differences in age,the length of hospital sta y,level of BNP and the history of falls in the past year(P<0.05).The risk factors for frailty in elderly inpatients with heart failure are age(OR=0.615;CI:0.421,0.921),the length of hospital stay(OR=0.764;CI:0.665,0.877),level of BNP(OR=0.998;CI:0.977,0.999),the history of falls in the pa st year(OR=0.159;CI:0.055,0.463).5.All the patients were divided into three groups according to LVEF,HFpEF group,HFmrEF group,HFrEF group.Comparison of detection rate of frailty among the three groups.There were 101 patients with HFpEF group,45 of them were frail,the detection rate was 44.5%;there were 58 patients with HFmrEF group,35 of them were frail,the detection rate was 60.3%;there were 46 patients with HFrEF group,28 of them were frail,the detection rate was 60.8%.HFrEF group had the highest detection rate of frail.In each group,the prevalence of frailty increases with age.6.All the frail group patients were divided into three groups according to LVEF,HFpEF,HFmrEF,HFrEF.Comparison of basic clinical date and laboratory indicators in three groups.The level of BNP in HFpEF group and HFmrEF group was significantly lower than that in HFrEF group.The age of HFrEF group was significantly lower than that in HFpEF group and HFmrEF group(P<0.05).Conclusions:1.The incidence of frailty in elderly inpatients with heart failure is very high.Attention should be paid to the identification of frailty in inpatients with heart failure,especially in the elderly people.2.Age,the length of hospital stay,level of BNP and the history of fall s in the past year were associated with the occurrence of frailty in elderly in patients with heart failure.The older the age,the higher the BNP,the longe r the length of hospital stay,the more vulnerable to frailty,and the older patie nts with heart failure who have fallen in the past year are more likely to frailty.BNP level also provides a new reference index for clinicians in the diagnosis o f frailty in elderly inpatients with heart failure.3.HFrEF patients are more likely to be frailty than HFpEF and HFmrEF p atients.Then the degree of frailty will increase with age in these three groups of patients. |
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