2025 年第 9 期 第 20 卷

住院老年心房颤动患者衰弱现状及影响因素分析

Analysis of the current status and influencing factors of frailty in hospitalized elderly patients with atrial fibrillation

作者：马伟钦1潘东1施倩2郭振邦1伍建军1李林1

英文作者：Ma Weiqin1 Pan Dong1 Shi Qian2 Guo Zhenbang1 Wu Jianjun1 Li Lin1

单位：1四川省巴中市中心医院心血管内科，巴中636600；2四川省巴中市中心医院介入室，巴中636600

英文单位：1Department of Cardiovascular Medicine Bazhong Central Hospital Sichuan Province Bazhong 636600 China; 2Intervention Room Bazhong Central Hospital Sichuan Province Bazhong 636600 China

关键词：心房颤动；住院老年患者；衰弱；影响因素

英文关键词：Atrialfibrillation;Hospitalizationelderlypatients;Frailty;Influencefactors

• 摘要：

• 目的 探讨住院老年心房颤动患者衰弱现状和影响因素。方法 收集2021年5月至2024年5月四川省巴中市中心医院诊治的106例住院老年心房颤动患者为研究对象，记录其临床资料，根据衰弱发生情况分为非衰弱组（56例）和衰弱组（50例）。采用多因素Logistic回归分析筛选住院老年心房颤动患者衰弱的影响因素并构建列线图预测模型；采用Bootstrap法内部验证，Hosmer-Lemeshow检验分析列线图预测模型一致性，绘制受试者工作特征（ROC）曲线分析模型区分度，校正曲线分析模型校准度。结果 106例住院老年心房颤动患者中，50例发生衰弱，发生率为47.2%。衰弱组30 d再入院率、90 d再入院率均高于非衰弱组［14.0%(7/50)比1.8%(1/56)、20.0%(10/50)比5.4%(3/56)］（均P＜0.05）。衰弱组年龄、Barthel指数评分＜60分比例大于/高于非衰弱组，血红蛋白、白蛋白均低于非衰弱组（均P＜0.05）。年龄增加、Barthel指数评分＜60分均是住院老年心房颤动患者衰弱的独立危险因素，血红蛋白增加、白蛋白增加均是住院老年心房颤动患者衰弱的保护因素（均P＜0.05）。列线图内部验证Hosmer-Lemeshow检验结果显示χ2=5.983，P=0.649；ROC曲线结果显示曲线下面积为0.864（95%置信区间：0.794～0.934），校正曲线结果显示实际概率和预测概率基本一致，曲线斜率接近1。结论 住院老年心房颤动患者衰弱发生率较高，年龄较大、Barthel指数评分＜60分、血红蛋白较低、白蛋白较低的患者更易发生衰弱。

• Objective To investigate the current status and influencing factors of frailty in hospitalized elderly patients with atrial fibrillation. Methods A total of 106 elderly inpatients with atrial fibrillation diagnosed and treated in Bazhong Central Hospital, Sichuan Province from May 2021 to May 2024 were collected as the research objects, and their clinical data were recorded. According to the occurrence of frailty, they were divided into non-frailty group (56 cases) and frailty group (50 cases). Multivariate Logistic regression analysis was used to screen the influencing factors of frailty in hospitalized elderly patients with atrial fibrillation. And construct a nomogram prediction model. The Bootstrap method was used for internal verification, the Hosmer-Lemeshow test was used to analyze the consistency of the nomogram prediction model, the receiver operating characteristic (ROC) curve was drawn to analyze the discrimination of the model, and the calibration curve was used to analyze the calibration of the model. Results Among 106 hospitalized elderly patients with atrial fibrillation, 50 patients developed frailty, with an incidence of 47.2%. The 30-day and 90-day readmission rates in the frailty group were higher than those in the non-frailty group ［14.0%(7/50) vs 1.8%(1/56), 20.0%(10/50) vs 5.4%(3/56)］(both P＜0.05). The age and the proportion of Barthel index score <60 in the frailty group were greater/higher than those in the non-frailty group, and the hemoglobin and albumin were lower than those in the non-frail group (all P<0.05). Increasing age and Barthel index score <60 were independent risk factors for frailty in hospitalized elderly patients with atrial fibrillation, and increasing hemoglobin and albumin were protective factors for frailty in hospitalized elderly patients with atrial fibrillation (all P<0.05). The Hosmer-Lemeshow test results  of internal validation of the nomogram showed χ2=5.983, P=0.649. The ROC curve results  showed that the area under the curve was 0.864 (95% confidence interval: 0.794-0.934). The calibration curve results  showed that the actual probability was basically consistent with the predicted probability, and the slope of the curve was close to 1. Conclusion The incidence of frailty in hospitalized elderly patients with atrial fibrillation is high. Patients with older age, Barthel index score <60, lower hemoglobin and lower albumin are more likely to have frailty.