Relationship Between Comprehensive Clinical Indicators And Frailty In Elderly Patients With COPD

Background:Chronic obstructive pulmonary disease?COPD?is a common,preventable and treatable disease.Due to continuous exposure to risk factors for COPD and aging of the global population,the prevalence and burden of COPD is expected to increase in the coming decades.Frailty is the most clinically significant geriatric syndrome that manifests as a decline in physical reserve function and is likely to cause adverse health outcomes.At the same time,frailty is a common comorbidity in elderly patients with chronic obstructive pulmonary disease.Therefore,it is particularly important to explore the risk factors that lead to the frailty of elderly patients with chronic obstructive pulmonary disease,so as to provide a theoretical basis for early prevention of frailty.Objective:This project collects clinical data of COPD patients,completed the Fried scale and MNA-SF scale assessment simultaneously.Analyze the differences and correlations in medical history,general conditions,laboratory indicators,pulmonary function indicators,and nutritional status among non-frail elderly COPD patients,pre-frail elderly COPD patients and frail elderly COPD patients.To investigate the influence of Comprehensive Clinical Indicators of elderly COPD patients on the incidence of frailty.Methods:In this cross-sectional study,patients with stable COPD who were admitted to the Department of Geriatrics and Respiratory medicine of the First Hospital of Shanxi Medical University from December 2018 to October 2019 were selected as the research objects,and their medical history,general conditions,laboratory indicators,and pulmonary function indicators were collected.Fried scale assessment and MNA-SF nutritional status assessment were conducted on the patients.According to Fried assessment results,frailty syndrome was diagnosed,and all the enrolled patients were divided into the non-frail group,the pre-frail group and the frail group.The differences and correlations in the medical history,general conditions,laboratory indicators,pulmonary function indicators and MNA-SF nutritional status of the three groups were analyzed,and the influence of the Comprehensive Clinical Indicators of elderly COPD patients on the incidence of frailty was discussed.Result:1.Incidence of frailty and Comparison of general data and frailty in elderly patients with COPD1.1 The incidence of frailty in elderly patients with COPDIn this study,a total of 83 elderly patients with COPD were collected.The included patients were assessed by Fried Scale,and 31?37.3%?patients were diagnosed as frailty,4?4.8%?non-frail patients,and 48?57.8%?pre-frail patients.1.2 General data relationships between different groupsThere were significant differences among the three groups in age,living alone,nutritional status,smoking index and smoking status?all P<0.05?.There was no difference among the three groups in gender,BMI,education level and other factors.2.Comparison of frailty status with clinical comprehensive indicators2.1 Comparison of frailty status with laboratory indicatorsComparison between the three groups of common laboratory indexes,it was found that with increasing frail degree,plasma albumin decline gradually,arterial blood lactate acid level,serum IL-6 and higher CRP level gradually,statistically significant difference?all P<0.05?.2.2 Comparison of frailty status with Pulmonary function indexComparing the pulmonary function indexes among the three groups,it was found that FEV₁%,FEV₁/FVC and PEF decreased in the frail group compared with the non-frail group and the pre-frail group,and CAT score and mMRC grading increased gradually,with statistically significant differences?all P<0.05?.In addition,patients with more than 2 acute exacerbations in the past 1 year were more frail?P=0.02?.3.Correlation analysis between frailty and Comprehensive Clinical IndicatorsAge,nutritional status,living alone,smoking index,arterial blood lactic acid level,serum IL-6 and serum CRP level were positively correlated with Fried score.Pulmonary function parameters FEV₁%,FEV₁/FVC,PEF and plasma Alb were negatively correlated with Fried scores?all P<0.05?.4.Risk factors for developing frailty in elderly COPD patientsLogistic regression models revealed that age,smoking index,Malnutrition,EOS%,IL-6 levels were related risk factors for frail COPD in elderly patients,and FEV₁%was protective factor?all P<0.05?.Conclusion:1.The incidence of frailty is high in elderly COPD patients,and the possibility of frailty increases with age.2.Age,living alone,smoking index,MNA-SF score,arterial blood Lac level,serum IL-6 level,serum CRP level,plasma Alb level,FEV₁%,FEV₁/FVC,and PEF were associated with the occurrence of frailty.3.Age,higher smoking index,malnutrition,EOS%and IL-6 were risk factors for frailty in the elderly COPD patients.