Abstract:

Objective　To investigate the conditions of frailty in elderly inpatients with pancreatic tumors, to collect their general information and pertinent laboratory indicators, to analyze the correlation between these factors and the occurrence of frailty, to assess the influencing factors of frailty in the patients, and to provide references for healthcare professionals in screening and treating frailty. Methods　Two hundred and fifteen elderly inpatients with pancreatic tumors who were ≥ 60 years old and and treated at First Ward Division, Department of Pancreatic Surgery, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University from January to October 2023 were selected for the case-control study. They were divided into a frail group and a non-frail group using a general information questionnaire and the questionnaire of Vulnerable Elders Survey-13 (VES-13). The clinical data and information were compared between the two groups. Data processing and analysis were performed using SPSS 22.0. The measurement data were expressed as median and interquartile range, and compared between the two groups using the Mann Whitney test. The count data were expressed as frequency and percentage, and compared between the two groups using the χ² test. Single-factor analysis was done. The factors with statistical differences in the single-factor analysis were selected for the binary multivariate logistic regression analysis. Results　This study included 215 patients, comprising 126 males and 89 females, with an age of (68.53±5.96) years. The incidence of frailty was 84.65% (182/215). There were no statistical differences between the two groups in gender, age, education level, special diseases, special medication status, food intake reduction in the past week, and history of chemotherapy or radiotherapy (all P>0.05). There were statistical differences in body mass index (BMI) , hemoglobin level, red blood cell count, immunoglobulin A (IgA) level, and D-dimer level between the two groups (all P<0.05). Low BMI (OR=0.176, 95%CI 0.086-0.361) and elevated IgA level (OR=1.839, 95%CI 1.094-3.091) were the independent risk factors for frailty in the inpatients (both P<0.05). Conclusions　The incidence of frailty in elderly inpatients with pancreatic tumors is high. Compared to non-frail elderly pancreatic tumor patients, the frail patients have lower BMI, hemoglobin, and red blood cell count and higher levels of IgA and D-dimer. BMI and IgA are independent risk factors for frailty. Healthcare professionals should proactively assess and screen for pertinent influencing factors, and intervene promptly against the risk factors.

Key words:

Frailty, Elderly inpatients, Pancreatic tumors, Associated factors

摘要：

目的　调查老年胰腺肿瘤住院患者衰弱状况，收集老年胰腺肿瘤患者一般资料及相关实验室指标，分析以上因素与老年胰腺肿瘤患者发生衰弱的相关性，分析衰弱影响因素，为临床医务人员筛查、干预衰弱提供参考。方法　选取2023年1月至10月上海交通大学医学院附属瑞金医院胰腺外科一病区60岁及以上的老年胰腺肿瘤住院患者215例进行病例对照研究。通过自制一般资料问卷和弱势老年人调查-13（Vulnerable Elders Survey-13，VES-13）问卷将患者分为衰弱组与非衰弱组。对比两组临床资料及数据。采用SPSS 22.0进行数据处理和数据分析。计量资料以中位数和四分位数间距表示，计量资料组间比较采用Mann Whitney检验。计数资料用频数和百分比表示，组间比较采用χ²检验。进行单因素分析，对单因素分析中差异有统计学意义的影响因素进行二元多因素logistic回归模型分析。结果　本研究共纳入215例患者，其中男126例，女89例，年龄（68.53±5.96）岁，衰弱发生率为84.65%（182/215）。两组性别、年龄、文化程度、特殊疾病、特殊服药、1周内有无食物减少、放化疗史比较，差异均无统计学意义（均P>0.05）。衰弱组体质量指数（body mass index，BMI）与非衰弱组比较，差异有统计学意义（P<0.05）。衰弱组血红蛋白、红细胞计数、免疫球蛋白A（immunoglobulin A，IgA）、D-二聚体水平与非衰弱组比较，差异均有统计学意义（均P<0.05）。低BMI（OR=0.176，95%CI 0.086～0.361）和IgA水平升高（OR=1.839，95%CI 1.094～3.091）是老年胰腺肿瘤住院患者发生衰弱的独立危险因素（均P<0.05）。结论　老年胰腺肿瘤住院患者的衰弱发生率较高；相较于非衰弱的老年胰腺肿瘤患者，评估为衰弱的老年胰腺肿瘤住院患者的BMI、血红蛋白、红细胞计数水平较低，而IgA、D-二聚体水平较高；低BMI与高IgA水平是发生衰弱的独立危险因素。临床医务人员应及早评估和筛查相关影响因素，并针对危险因素进行及早干预。

关键词:

衰弱, 老年住院患者, 胰腺肿瘤, 相关因素