目的:了解中国维持性血液透析患者前期衰弱和衰弱的患病率及其危险因素。
方法:横断面研究。
方法:2017年1月至7月,采用便利抽样法,来自连云港市六所医院的503名维持性血液透析患者,中国,被招募参加这项研究。参与者的社会人口统计,使用一般信息问卷评估生活方式因素和健康信息.基于Fried脆弱表型评估脆弱。进行了多分类逻辑回归,以检查与该人群的前期虚弱和虚弱相关的因素,包括年龄,性别,独自生活,employment,教育水平,身体质量指数,人均家庭月收入,吸烟状况,锻炼状态,初步诊断,透析年龄,透析频率,血管通路,充血性心力衰竭,其他心脏病,脑血管疾病,外周血疾病,疼痛,白蛋白水平和血红蛋白水平。
结果:在平均年龄为53.02岁(标准偏差14.99)的503名参与者中,178人患有预虚弱(35.3%),大多是年轻人和中年人。在<60岁的参与者中,前期虚弱的患病率超过40%。回归分析表明,缺乏运动,透析年龄≤12个月,充血性心力衰竭和其他心脏病与衰弱前期呈正相关。二百一十八名参与者身体虚弱(43.3%),其中大多数年龄≥60岁。≥60岁参与者的虚弱患病率为71.4%。回归分析表明,高龄,作为女性,肥胖,家庭人均月收入低,缺乏锻炼,糖尿病是主要疾病,透析年龄≤12个月,充血性心力衰竭,其他心脏病,疼痛和低白蛋白水平,与虚弱呈正相关。此外,超过一半的参与者几乎没有锻炼(64.6%),而缺乏运动是前期虚弱和虚弱的危险因素。三分之一的参与者有疼痛(33.4%),而疼痛是这些参与者前期虚弱和虚弱的独立危险因素.
结论:前期虚弱和虚弱在维持性血液透析患者中很常见。大多数老年维持性血液透析患者身体虚弱,大多数中青年患者都是虚弱的。临床医师应积极筛查维持性血液透析患者的前期衰弱和衰弱,尤其是透析年龄≤12个月的患者。许多因素会影响该人群的虚弱前期和虚弱。应根据这些因素设计和实施量身定制的干预措施,优先为患者提供运动指导和疼痛管理,以帮助他们预防或逆转前期虚弱和虚弱。
OBJECTIVE: To examine the prevalence and risk factors of pre-frailty and frailty in maintenance haemodialysis patients in China.
METHODS: A cross-sectional
study.
METHODS: From January to July 2017, using the convenience sampling method, a total of 503 maintenance haemodialysis patients from six hospitals in Lianyungang, China, were recruited for this
study. The participants\' socio-demographic, lifestyle factors and health information were assessed using a general information questionnaire. Frailty was evaluated based on the Fried frailty phenotype. Multi-categorical logistic regression was performed to examine factors associated with pre-frailty and frailty in this population, including age, sex, living alone, employment, educational level, body mass index, per capita monthly household income, smoking status, exercise status, primary diagnosis, dialysis age, frequency of dialysis, vascular access, congestive heart failure, other cardiac diseases, cerebrovascular disease, peripheral blood diseases, pain, albumin level and haemoglobin level.
RESULTS: Among the 503 participants with an average age of 53.02 years (standard deviation 14.99), 178 had pre-frailty (35.3%) and were mostly young and middle-aged. The prevalence of pre-frailty among participants <60 years old was more than 40%. Regression analysis showed that lack of exercise, dialysis age ≤12 months, congestive heart failure and other cardiac diseases were positively associated with pre-frailty. Two hundred and eighteen participants were frail (43.3%), most of whom were aged ≥60. The prevalence of frailty in participants ≥60 was 71.4%. Regression analysis showed that advanced age, being female, obesity, low per capita monthly household income, lack of exercise, diabetes as the primary disease, dialysis age ≤12 months, congestive heart failure, other cardiac diseases, pain and low albumin level, were positively associated with frailty. In addition, more than half of the participants hardly exercised (64.6%), while lack of exercise was a risk factor for pre-frailty and frailty. A third of the participants had pain (33.4%), while pain was an independent risk factor for pre-frailty and frailty in these participants.
CONCLUSIONS: Pre-frailty and frailty are common in patients with maintenance haemodialysis. Most of the elderly maintenance haemodialysis patients are frail, and most of the young and middle-aged patients are pre-frail. Clinicians should actively screen the pre-frailty and frailty among patients with maintenance haemodialysis, especially those with dialysis age ≤12 months. Many factors affect pre-frailty and frailty in this population. Tailored intervention measures should be designed and implemented based on these factors, giving priority to exercise guidance and pain management for patients to help them prevent or reverse pre-frailty and frailty.