Abstract:

Objective　To investigate the risk factors of chronic heart failure (CHF) complicated with frailty in the elderly. Methods　This study was a retrospective analysis. One hundred and sixty elderly patients with CHF treated in Henan Provincial People's Hospital from November 2021 to November 2024 were selected as the study objects. One hundred and fifty questionnaires were recovered, including 71 males (47.33%) and 79 females (52.67%) who were (74.29±5.15) years old. The patients' general information and frailty conditions were investigated by questionnaire survey and medical record review. The patients were divided into a frailty group and a non-frailty group according to whether they were complicated with frailty or not; the general information of the two groups was compared. t and χ² tests and binary logistic regression were used to analyze the risk factors of CHF complicated with frailty in the elderly. Results　One hundred and fifty valid questionnaires were recovered, with a questionnaire recovery rate of 93.75%; 52 of the 150 elderly CHF patients were complicated with frailty, with an incidence rate of 34.67%. There were no statistical differences in gender, education level, smoking history, drinking history, and medical payment methods between the two group (all P>0.05); however, the age and the proportions of the patients with BMI > 24.0 kg/m², NYHA grade III-IV, and ≥2 underlying diseases and who lived alone and had malnutrition and sleep disorders in the frailty group were higher than those in the non-frailty group [(75.51±5.36) years vs. (73.65±5.04) years, 15.38% vs. 3.06%, 92.30% vs. 40.82%, 57.69% vs. 29.59%, 55.77% vs. 34.69%, 53.85% vs. 15.31%, and 61.54% vs. 30.61%], with statistical differences (all P<0.05). The results of binary logistic regression analysis showed that BMI > 24.0 kg/m², NYHA grade III-IV, ≥ 2 underlying diseases, malnutrition, and sleep disorders were the risk factors of the elderly CHF patients complicated with frailty. Conclusions　The incidence rate of CHF complicated with frailty in the elderly is high. Its occurrence is closely related to BMI, NYHA grade, underlying diseases, nutritional status, and sleep quality. Clinical intervention strategies should be adopted to reduce the incidence of CHF complicated with frailty in the elderly.

Key words:

Chronic heart failure, Frailty, Elderly, Risk factors, Intervention strategies

摘要：

目的　探究老年慢性心力衰竭（CHF）合并衰弱相关危险因素。方法　本研究为回顾性分析，选择问卷调查2021年11月至2024年11月在河南省人民医院治疗的老年CHF患者160例，回收有效问卷150例，其中男71例（47.33%）、女79例（52.67%），年龄（74.29±5.15）岁；通过问卷调查和病历回顾统计患者的一般资料和合并衰弱情况，按是否合并衰弱分为衰弱组、非衰弱组，对比两组一般资料，使用t检验、χ²检验以及二元Logistic回归分析老年CHF合并衰弱的危险因素。结果　回收有效问卷150份，问卷回收率93.75%；150例老年CHF患者中，有52例合并衰弱，发生率为34.67%。两组一般资料对比显示，性别、文化程度、吸烟史、饮酒史、医疗付费方式差异均无统计学意义（均P>0.05），但衰弱组年龄大于非衰弱组［（75.51±5.36）岁比（73.65±5.04）岁］，BMI>24.0 kg/m²（15.38%比3.06%）、NYHA分级为Ⅲ~Ⅳ级（92.30%比40.82%）、合并基础疾病≥2种（57.69%比29.59%）、独居（55.77%比34.69%）、营养不良（53.85%比15.31%）及睡眠障碍（61.54%比30.61%）患者比例均高于非衰弱组，差异均有统计学意义（均P<0.05）；二元Logistic回归分析结果显示，BMI>24.0 kg/m²、NYHA分级为Ⅲ～Ⅳ级、合并基础疾病≥2种、营养不良、睡眠障碍为老年CHF合并衰弱的危险因素。结论　老年CHF合并衰弱具有较高的发病率，其发生与BMI、NYHA分级、合并基础疾病情况、营养状况、睡眠质量密切相关，临床上应采取相应的干预策略来降低老年CHF合并衰弱的发生。

关键词:

慢性心力衰竭, 衰弱, 老年, 危险因素, 干预策略