Analysis Of The Frail Status And Influencing Factors In Elderly Inpatients With Fracture

Objective:To analyze the frail status and its influencing factors of the elderly inpatients with fracture,so as to provide reference for preventing frailty and delaying its progress.Methods:From November 2018 to October 2019,165 elderly fracture patients were selected from the department of orthopaedic of Chengde central hospital.The FRAIL scale was used to evaluate the frail status of the patients.165 patients were divided into frail group and non-frail group,then the clinical data of the two groups were compared.SPSS 22.0 software was used for statistical analysis of data to test the normality of measurement data.Measurement data conforming to normal distribution was expressed in x ± s,and the difference between two groups were compared by independent sample t-test;measurement data not conforming to normal distribution was expressed in M(P₂₅,P₇₅)or converted to grade data was expressed in cases?%?,and the two groups were compared by nonparametric test of rank conversion.The enumeration data were expressed in the number of cases?%?,and the differences between the two groups were compared by ?²-test.Multiple factors logistic regression analysis was used to explore the risk factors of frailty in elderly inpatients with fracture,and the difference was statistically significant?P < 0.05?.Results:1.General data comparison: a total of 165 patients were selected,with an average age of 71.18 ± 8.38 years,including 106 females and 59 males;96in the frail group?58.2%?and 69 in the non-frail group?41.8%?;68 in the frail group?70.8%?and 28 in the non-frail group?29.2%?.The average age and Body mass index?BMI,kg / m²?were 72.50 ± 8.15,69.33 ± 8.42 and 23.15 ±3.74 and 23.18 ± 3.28,respectively.There were statistically significant differences in age,gender,educational level,Activities of daily living?ADL?score before fracture,nutritional risk index for the geriatric?GNRI?,hospitalization days,and fracture site between the two groups?P < 0.05?;There was no significant difference in BMI,marital status,living alone,drinking history,smoking history,hypertension classification,fall history in the past year,operation history,number of comorbidity,time between fracture admission,treatment plan,fracture mechanism classification between the two groups?P > 0.05?.2.Comparison of the prevalence of frailty in different age groups: 82 patients aged 60-69 years,40 patients?48.8%?were frail;47 patients aged70-79 years,31 patients?66.0%?were frail;36 patients aged ? 80 years,25patients?69.4%?were frail;The prevalence of frailty in elderly inpatients increased with age.3.Comparison of laboratory indexes: White blood cells?WBC?,Red blood cells?RBC?,Hemoglobin?Hb?,Neutrophils percentage?Ne?and Albumin?ALB?in the frail group and the non-frail group were statistically different?P < 0.05?,while Low-density lipoprotein cholesterol?LDL-C?and Creatinine?CR?were not statistically different?P > 0.05?.4.The results of multiple factors logistic regression analysis showed that the OR Values of hospitalization days was 3.354?1.348,8.345??P < 0.05?,and the hospitalization time of elderly inpatients with fracture was prolonged after fiailty;ADL score before fracture and Ne were the risk factors that significantly affected the frailty of the elderly inpatients with fracture.The OR Values were 4.795?1.419,16.207?,0.929?0.883,0.978?,respectively?P <0.05?.The elderly patients with impaired activities of daily living and increased percentage of neutrophils are more likely to suffer from frailty.5.Comparison of frailty prevalence rate of fracture inpatients in different parts: all patients were divided into four groups according to different parts of fracture,namely head and upper limb group,lower limb group,trunk group and mixed group.There were 14 cases in the head and upper limbs group,2cases?14.3%?in frailty,93 cases in the lower limbs group,59 cases?63.4%?in frailty,40 cases in the trunk group,25 cases?62.5%?in frailty,18 cases in the mixed group,10 cases?55.6%?in frailty.Patients with lower extremity fractures have a higher rate of frailty.6.69 patients in the non-frail group were divided into the healthy elderly group?16 cases??24.6%?and the prefrail group?53 cases??81.5%?according to the degree of frailty.There was a significant difference in the number of comorbidity between the two groups.The patients with more comorbidities were more likely to enter the prefrailty.The age,gender,marital status,living alone,drinking history,smoking history,educational level,BMI,systolic blood pressure,diastolic blood pressure,fall history in the past year,operation history,GNRI,ADL score before fracture,hospitalization days,classification of fracture site,time between fracture and admission,treatment plan,classification of fracture mechanism,and laboratory indexes of the two groups were no statistically significant difference?P > 0.05?.Conclusion:1.The incidence of frailty in elderly patients with fracture is high.We should pay attention to the evaluation of frailty in patients with fracture,especially the elderly inpatients with fracture.2.Age,gender,education level,ADL score before fracture,GNRI,hospitalization days,classification of fracture site,WBC,RBC,Hb,Ne,ALB were related to the frailty of the elderly inpatients with fracture.The hospitalization time of elderly inpatients with fracture was prolonged after fiailty.The elderly patients with impaired activities of daily living and increased percentage of neutrophils are more likely to suffer from frailty.3.The prevalence of frailty after fracture of the lower limbs in the elderly is higher than that of other fractures.