老年人便秘与衰弱的相关性

Correlation between constipation and frailty in the elderly

摘要:

目的 探讨老年人便秘与衰弱的相关性,为临床干预提供依据。方法 回顾性分析北京协和医院老年医学科473例住院老年患者的综合评估资料,便秘采用症状诊断,衰弱应用FRAIL量表及躯体功能评估。采用SPSS 20.0统计软件进行分析。根据数据类型,分别采用t检验、方差分析或χ²检验进行组间比较, 采用logistic回归分析衰弱与便秘的相关性。结果 便秘发生率无衰弱患者为20.1%(49/244),衰弱前期患者为31.5%(51/162),而衰弱患者为47.8%(32/67),各组间比较差异有统计学意义(χ²=21.58,P<0.001)。便秘患者较无便秘者躯体功能较差,5次起坐分别为[(14.0±8.8)和(11.7±5.4)s]、最大握力分别为[(23.8±8.5)和(26.2±9.0)kg]、简易体能状况量表评分分别为[(9.1±3.1)和(10.2±2.6)分],组间比较差异均有统计学意义(P<0.05)。此外,多因素logistic回归提示便秘与衰弱、抑郁及跌倒相关(P<0.05)。结论 老年人便秘与衰弱密切相关,与体能下降和老年综合征呈共病状态,需要全人管理。

Abstract:

Objective To explore the correlation between constipation and frailty in the elderly in order to provide the evidence for clinical intervention. Methods A retrospective analysis was carried out on the comprehensive data from 473 hospitalized elderly patients admitted to Department of Geriatrics, Peking Union Medical College Hospital from September 2016 to June 2019. Constipation was diagnosed by symptoms, and status of frailty was assessed by FRAIL scale and physical function evaluation. SPSS statistics 20.0 was used for data analysis. According to different data type, t test, variance analysis orχ² test was used for data comparison, and logistic regression was used to analyze the correlation between frailty and constipation.Results The prevalence of constipation was 20.1% (49/244) in the non-frailty patients, 31.5% (51/162) in the pre-frailty patients, and 47.8% (32/67) in the frail patients, and the differences were statistically significant among the three groups (χ²=21.58, P<0.001). The constipation patients had poor physical function, with longer time in 5-times sit-stand test [(14.0±8.8) vs (11.7±5.4) s], lower maximum handgrip strength [(23.8±8.5) vs (26.2±9.0) kg], and lower points of short physical performance battery (SPPB) [(9.1±3.1) vs (10.2±2.6)points] when compared with the patients without constipation (P<0.05). In addition, multivariate logistic regression showed that constipation was related to frailty, depression and falls (P<0.05). Conclusion In the elderly, constipation is closely related to frailty, and comorbid with declined physical function and geriatric syndromes, needing comprehensive care.