Investigation Of The Frailty Of Elderly Hospitalized Diabetes Patients And Analysis Of The Influencing Factors

Objective: By investigating the frailty status of elderly diabetic patients in a third-class hospital in Karamay City,Xinjiang Province,this paper explores the influence of different factors on the frailty,helps clinical medical staff to identify the frailty status of diabetic patients as early as possible,so as to formulate a more reasonable and accurate treatment and nursing program;through the analysis of risk diagnosis efficiency,the best cut-off point of influencing factors is calculated,so as to improve and unify the decline in the future.The frailty assessment scale provides a reference basis.Methods: 1.A convenience sampling survey was conducted among type 2 diabetes patients aged over 60 years in geriatrics and endocrinology departments of a third-class hospital in Karamay,Xinjiang,from November 2017 to August 2018.The patients were divided into three groups by the Frailty Phenotype Scale: non-frailty,pre-frailty and frailty.The influencing factors of elderly inpatients' frailty were investigated by self-made general demographic scale,Geriatric Depression Scale-15,Pittsburgh Sleep Quality Index and Geriatric Locomotive Function Scale.2.Epi Data 3.1 software is used for data input and SPSS 23.0 software package is used for data analysis.Statistical methods: Descriptive statistical analysis was used to analyze the general data of the subjects,such as locomotive function score,depression score and sleep quality index score;variance analysis,chi-square test and rank sum test to compare the differences of senile diabetic patients' frailty in general data;Multinomial Logistic Regression was used to analyze the influencing factors of senile diabetic patients' frailty,ROC curve was used to effectiveness analysis of risk diagnosis.Results: 1.Among 431 elderly patients with diabetes mellitus,128 (29.7%) had non-frailty,159 (36.9%) had prefrailty and 144 (33.4%) had frailty.There were 68 depressive patients (15.8%),224 patients (52.0%) with poor sleep quality and 157 patients (36.4%) with locomotive dysfunction.2.Univariate analysis showed that gender,age,marriage,mode of payment,nationality,living style,duration of disease,frequency of hypoglycemia,use of insulin,number of repeated visits,complications of diabetes mellitus,other diseases,fasting plasma glucose,2-hour postprandial blood glucose,Hemoglobin A1C,depression,locomotive function and sleep quality were significant differences among the three groups (P < 0.05).3.Multinomial Logistic Regression analysis showed that gender,age,complications of diabetes mellitus (>3),complications of diabetes mellitus (>2),Hemoglobin A1C,sleep quality index score,depression score and locomotive function score were significant risk factors for elderly diabetes mellitus inpatients (OR>1,P <0.05).4.ROC curve analysis showed that the diagnostic efficacy for the risk of elderly diabetes mellitus frailty was as follows: AUC of Hemoglobin A1C was 0.653,the best cut-off point was 8.15%;AUC of age was 0.674,the best cut-off point was 68.5;AUC of Pittsburgh Sleep Quality Index Scale was 0.731,the best cut-off point was 6.5;AUC of Geriatric Depression Scale was 0.810,the best cut-off point was 4.5;AUC of Locomotive Function Score was 0.900,the best.The cut-off point is 7.5.Conclusion: 1.The frailty of the elderly patients with diabetes mellitus are at a moderate level in Karamay City,Xinjiang Province,so medical staff should pay attention to it as soon as possible.2.The older age,female,the more chronic complications of diabetes mellitus (>3) and other diseases (>2),the higher level of Hemoglobin A1C,the more likely depression score,sleep quality index score and locomotive function score are to be more frailty.3.It is suggested that the frailty screening should be included in the admission assessment of elderly diabetic patients so that medical staff can identify the frailty status as soon as possible,formulate a more reasonable and accurate program.4.This study concluded that age (>68.5 years old),sleep quality score (>6.5),depression score (>4.5),Hemoglobin A1C (>8.15%) and locomotive function score (>7.5) provided a reference basis for formulating the criteria of elderly diabetes patients' frailty assessment in the future,and promoted the popularization of frailty assessment in clinical.