Investigation On The Frailty Status And Risk Factors Of The Elderly Observed In Emergency Department

Objective:This study collected the general information and related laboratory indicators of the elderly observed in the emergency department,analyzed the correlation between the above factors and the patients' frailty status,to evaluate the frailty and analyze risk factors of those who are observed in the emergency department in elderly and provide a reference for the health education of the elderly and the screening and intervention of clinical physicians and nurses.Methods:This study is a single-center cross-sectional study.The elderly patients who were treated in the emergency department of Chengde Central Hospital and staying for observation were collected continuously from October 2018 to January 2020.Questionnaires were made with 13 factors,including age,gender,education level,marriage,body mass index(BMI),comorbidity,polypharmacy,white blood cells(WBC),hemoglobin(Hb),creatinine(Cr),natrium(Na),kalium(K),lactic acid(LAC).Establish database.Frail scale was used to evaluate the frailty of elderly patients in the emergency department within 24 hours after admission.According to whether they were with frailty or not,all patients who meet the inclusion criteria are divided into frailty group and non-frailty group.The effective data were recorded into spss22.0 for processing and analysis after the survey data being sorted out.Kolmogorov Smirnov test was used to evaluate the normal distribution of measurement data,and the abnormal distribution data was represented by median and quartile spacing.Some measurement data were transformed into ordinal multi-classification variable data.Wilcoxon rank-sum test was used for intergroup comparison,and ?2 test was used for single factor analysis for intergroup comparison of count data.Binary multivariate logistic regression model was performed that the risk factors with statistical significance in the single factor analysis were selected as independent variables,while whether they were frail or not was the independent variable.According to the FRAIL score,all the participants who met the inclusion criteria were divided into three groups: healthy group,prefrail group and frail group.Kruskal Wallis test was used to analyze the statistically significant influencing factors of the three groups.Nemenyi test was used multiple comparisons among the three groups,and Spearman analysis was used to analyze the correlation between the influencing factors and frail status.The differences were statistically significant at P<0.05.Results:1.Totally 160 participants were included in this study.According to the evaluation results of the FRAIL scale,74(46.25%)patients were divided into the frail group,86(53.75%)patients in the non-frail group.There were 79(49.4%)male cases,of which 35(44.3%)participants were frail.81(50.6%)cases were female,of which 39(48.1%)participants were frail.There were significant differences in age,education,BMI,comorbidity,polypharmacy and Hb between the two groups(P<0.05).2.The status of frailty in the elderly patients of different age groups: 73 patients aged 60?69,including 24(32.9%)frail patients;50 patients aged 70?79,including 26(52.0%)frail patients;37 patients aged 80 and over,including 24(64.9%)frail patients.The prevalence of frailty increased with age growth.3.The results of multivariate logistic regression analysis showed that education,comorbidity,polypharmacy,and Hb all had significant effects on the frailty of elderly patients observed in the emergency department(P<0.05),after adjusting for age,gender,BMI,with OR values were 0.605(0.381,0.962),3.688(1.720,7.910),1.795(1.020,3.159)and 0.471(0.277,0.800),respectively.4.According to the FRAIL score,the patients were divided into three groups: 31(19.375%)cases were not frail,55(34.375%)cases were prefrail,74(46.25%)cases were frail group.Frail and prefrail groups were accounting for 80.6%.Kruskal Wallis test showed that the age,comorbidity,polypharmacy and Hb of the three groups were significantly different(P<0.05),and the H values were 13.400,25.287,11.564 and 11.910,respectively.Nemenyi test showed that there were statistical differences between the not frail group and the frailty group in the above 4 indicators(P<0.05),?2 values were 12.231,22.395,10.854 and 6.748,respectively;there were statistical differences in comorbidity and Hb levels between the prefrail group and the frail group(P<0.05),?2 values were 10.635 and 0.700,respectively.There was a positive correlation among age,comorbidity,polypharmacy and frailty(P<0.05),with correlation coefficients of 0.290,0.498 and 0.329,respectively.While there was a negative correlation between Hb and frailty(P<0.05),with a correlation coefficient of-0.272.Conclusion:1.The proportion of the elderly patients observed in the emergency department is relatively high,so those who should be screened frailty in time.2.Compared with the healthy elderly,the elderly patients with frailty were older,less educated,with lower BMI,comorbidity,polypharmacy and lower hemoglobin.3.Low level of education and Hb,comorbidity and polypharmacy are the risk factors for the frail of the elderly patients in the emergency department.