Correlation Study Of Elderly Frailty And Its Phenotype With Inflammatory Response And Coagulation Function

Objective:To investigate the relationship between elderly frailty and inflammatory response and coagulation function.According to the Fried frailty phenotypic evaluation methods elderly patients can be divided into different phenotype subgroup analysis,further explore different frailty phenotype and the relationship between response and coagulation function,providing the basis for further research.Method:1.Select patients aged 70 years or older who were hospitalized in the geriatrics department of Yuhuangding Hospital of Yantai from January 2018 to June2018.Finally,283 subjects were selected according to inclusion criteria and exclusion criteria.2.Measurethe total white blood cell count(WBC),C-reactive protein(CRP),interleukin-6(IL-6),prothrombin time(PT),activated partial thromboplastin time(APTT),D-dimer and fibrinogen(FIB)in all subjects and collecte age,sex,level of education,height,weight,grip strength and walking speed.3.The investigators designed a questionnaire based on Fried’s phenotypic evaluation of frailty,completed the frailty evaluation,and grouped according to their scores:(1)according to degree of frailty,the patients were divided into non-frailty group,pre-frailty group and frailty group;(2)according to different frailty phenotypes,the patients were divided into weight loss group,walking speed reduction group,grip strength loss group,physical weakness group and fatigue group.4.Analyze the correlation between elderly frailty and its phenotype with inflammatory response and coagulation function.5.All data were analyzed by SPSS 23.0software.Quantitative data were described in the form of mean?standard deviation(?x±s),counting data were expressed as examples and percentages.Single-factor tests were performed using the ANOVA,t-test,orχ~2test for hypothesis testing.Logistic binary regression analysis was used to analyze the risk factors of weakness.The test level was P<0.05 with statistical significance.Results:1.A total of 283 subjects were included in this study,including 121 patients with frailty,85 patients with pre-frailty and 77 patients without frailty.The prevalence of frailty was 42.8%.2.There were significant differences in age,BMI and education level among different groups(P<0.05).Age and BMI of the frailty group were higher than those of the non-frailty group and the pre-frailty group,and the education level of the non-frailty group was higher than those of the pre-frailty group and the pre-frailty group.3.The WBC,CRP,IL-6,PT,FIB and D-dimer of different frailty groups had statistical significance(P<0.05).WBC,CRP,IL-6,PT,FIB and D-dimer of frailty group were significantly higher than those of non-frailty group and pre-frailty group(P<0.05),and WBC,CRP,IL-6,PT,FIB and D-dimer of male and female groups had statistical significance(P<0.05).4.The relationship between different frailty phenotypes and inflammatory response indicators:WBC,CRP and IL-6 were significantly increased in weight-loss group,slow-walking group,grip-loss group,low-physical activity group and exhaustion group(P<0.05).5.The relationship between different frailty phenotypes and coagulation function related indicators:PT,D-dimer,FIB were significantly increased in the weight-loss group(P<0.05),APTT had no significant difference(P>0.05);D-dimer and FIB were significantly increased in the slow-walking group(P>0.05);PT,APTT had no significant difference(P>0.05);PT,APTT,D-dimer and FIB were significantly increased in the grip-loss group(P<0.05);PT,D-dimer and FIB were significantly increased in the descending group(P<0.05),but there was no significant difference in APTT;PT,APTT,D-dimer and FIB were significantly increased in the exhaustion group(P<0.05).6.Logistic regression analysis showed that age,WBC,CRP,IL-6,D-dimer and FIB were risk factors forelderly frailty(P<0.05).The prolongation of PT and APT were not risk factors forelderly frailty.Conclusions:1.Inflammatory reaction and coagulation activation are correlated with frailty.Some inflammatory factors(WBC,CRP,IL-6)and coagulation indicators(FIB,D-dimer)may have diagnostic value for frailty patients with frailty.2.WBC,CRP,IL-6,FIB and D-dimer of different frailty phenotypes were significantly increased,which further verified the correlation between frailty and inflammatory factors and coagulation indicators.3.Age,WBC,CRP,IL-6,D-dimer and FIB are risk factors for frailty.