衰弱量表评分及衰弱指数与老年患者髋关节置换术后康复效果的相关性分析

关键词：衰弱量表  衰弱指数  老年  髋关节置换术  康复效果

Keywords:the frail scale  frailty index  elderly  hip replacement  rehabilitation effect

摘要：

      摘要 目的：探讨衰弱量表（the frail scale）评分及衰弱指数（frailty index，FI）与老年患者髋关节置换术后康复效果的相关性。 方法：选取2020年1月—2022年1月在本院行髋关节置换术并进行术后康复训练的老年患者69例为研究对象，采用衰弱量表和FI评估所有患者入院时的衰弱状态。并采用Harris评分量表对患者术后1周、6周以及3个月时关节功能康复情况进行评估，按照术后3个月的Harris评分将患者分为康复效果优良组（50例）和不良组（19例），比较两组衰弱量表和FI差异，ROC曲线及Logistic回归评估衰弱量表和FI对康复效果的预测价值。 结果：69例老年患者术后3个月的总体康复效果优良（Harris评分78.72±5.56）。康复效果优良组衰弱量表和FI评估的衰弱比例均低于不良组，且两种衰弱评估结果均与术后3个月康复效果呈负相关（r=﹣0.393，P=0.001；r=﹣0.378，P=0.001）；ROC曲线分析结果显示衰弱量表和FI预测康复效果的ROC曲线下面积（AUC）分别为0.818、0.706；Logistic回归结果显示衰弱量表评分是术后康复效果的独立影响因素[OR（95%CI）=7.712（1.362—43.655），P=0.021]。 结论：衰弱评估量表和衰弱指数均与老年患者髋关节置换术后康复效果相关，其中衰弱量表预测性能相对更高。

Abstract:

      Abstract Objective：To investigate the correlation between the frail scale and frailty index （FI） with the rehabilitation results of elderly patients after hip replacement. Method：Sixty-nine elderly patients who underwent hip replacement and postoperative rehabilitation training in the authors’ hospital from January 2020 to January 2022 were selected for the study. The frail scale and FI were used to assess the frailty state of all patients at the time of admission. The joint functional recovery of patients was assessed by the Harris scale at 1 week， 6 week， and 3 months after operation， and the patients were divided into the excellent-outcome group （50 cases） and poor-outcome group （19 cases） according to the rehabilitation effect at 3 months after surgery. Result：The overall rehabilitation outcome of 69 elderly patients at 3 months after surgery was excellent（Harris score 78.72±5.56>75）. The languisher rate assessed by the frail scale and FI in the good-outcome group were lower than that of the poor-outcome group， and both frailty assessment results were negatively correlated with the rehabilitation effect 3 months after surgery （r=﹣0.393， P=0.001； r=﹣0.378， P=0.001）； the values of the area under ROC curve （AUC） of FI and the frail scale to predict recovery was 0.818 and 0.706， respectively； the logistic regression results showed that the frail scale was an independent factor in postoperative recovery [OR（95%CI）=7.712 （1.362—43.655）， P=0.021]. Conclusion：The frail scale assessment scale and FI are closely related to the rehabilitation effect of elderly patients after hip replacement， and the frail scale has a relatively higher predictive performance.