临床衰弱评分与老年冠心病病人短期预后的关系

牛培英; 卢海龙; 王婧欣; 张丹丹; 李雷

doi:10.13898/j.cnki.issn.1000-2200.2021.11.022

临床衰弱评分与老年冠心病病人短期预后的关系

The relationship between clinical asthenia scale(CFS) and short-term prognosis of elderly patients with coronary heart disease

摘要

摘要:
目的探讨临床衰弱评分（CFS）与老年冠心病（CAD）病人短期预后的关系。
方法选取老年CAD病人120例，均接受介入治疗，治疗前行CFS评分。根据病人的短期预后情况，分成预后良好组和预后不良组，将死亡者、出现严重不良事件者纳入预后不良组，将无事件生存者纳入预后良好组。比较2组CFS评分，绘制受试者工作特征曲线（ROC）分析CFS评分对老年CAD病人短期预后不良的预测价值，确定曲线下面积（AUC）、最佳界值。根据CFS评分，将病人分成衰弱组和无衰弱组，分析衰弱与病人临床特征的关系。
结果在120例病人中，有28例（23.33%）预后不良，92例（76.67%）预后良好。在28例预后不良者中，院内死亡4例（14.29%）（其中心力衰弱3例，心源性休克1例），泌尿系感染9例（32.14%），严重出血5例（17.86%）、上呼吸道感染10例（35.71%）。预后良好组CFS评分为（4.13±0.56）分低于预后不良组的（6.02±1.61）分，差异有统计学意义（P < 0.01）。CFS评分预测老年CAD短期预后不良的AUC为0.704（标准误=0.055，P < 0.01，95% CI=0.597~0.811），最佳界值为5.475分。衰弱组和无衰弱组疾病类型和病变数量分布差异有统计学意义，其中衰弱组不稳定型心绞痛、双支病变与三支病变占比高于无衰弱组（P < 0.01）。衰弱组和无衰弱组的病变部位以及高脂血症率、糖尿病率、高血压率、吸烟率差异均无统计学意义（P>0.05）。
结论与短期预后良好者相比，预后不良者的CFS评分明显增高，CFS评分对老年冠心病病人的短期预后具有一定预测价值，且CFS评分可能受冠心病类型、病变数量的影响。

Abstract:
ObjectiveTo explore the relationship between clinical asthenia scale(CFS) and short-term prognosis in elderly patients with coronary heart disease(CAD).
MethodsOne hundred and twenty elderly CAD patients were treated with intervention, and the CFS scores of the patients before treatment were evaluated.According to the short-term prognosis, the patients were divided into the good prognosis group(survivors without events) and poor prognosis group(death or serious adverse event patients).The CFS score between two groups was compared, and the receiver operating characteristic curve(ROC) was drawn to analyze the predictive value of CFS score for the poor short-term prognosis of elderly CAD patients, and the area under the curve(AUC) and optimal boundary value were determined.According to the CFS score, the patients were divided into the weak group and nonweak group, and the relationship between frailty and patients' clinical characteristics were analyzed.
ResultsAmong 120 patients, the prognosis of 28(23.33%)patients were poor, and the prognosis of 92(76.67%) patients were good.Among 28 patients with poor prognosis, 4 cases(14.29%) died in hospital(including 3 cases with heart failure and 1 casewith cardiogenic shock), 9(32.14%) cases were urinary tract infection, 5(17.86%) cases were severe bleeding, and 10(35.71%) cases were upper respiratory tract infection.The CFS score in good prognosis group(4.13±0.56) was significantly lower than that in poor prognosis group(6.02±1.61)(P < 0.01).The AUC of CFS was 0.704(standard error=0.055, P < 0.01, 95% CI=0.597-0.811), and the optimal boundary value was 5.475.The differences of the types of disease and number of lesions between the weak group and nonweak group were statistically significant(P < 0.01), and the proportios of unstable angina pectoris, double-branch lesions and three-branch lesions in weak group were higher than those in nonweak group(P < 0.01).The differences of the lesion site, hyperlipidemia rate, diabetes rate, hypertension rate and smoking rate between weak group and nonweak group were not statistically significant(P>0.05).
ConclusionsCompared with the patients with good short-term prognosis, the CFS scores of e patients with poor prognosis significantly increase.The CFS score has a certain predictive value for the short-term prognosis of the elderly patients with CHD, and the CFS score may be affected by the type of CHD and number of lesions.

HTML全文

参考文献(16)

施引文献

资源附件(0)