Risk factors and prediction model construction for preoperative frailty in elderly patients with spinal degenerative diseases
10.3760/cma.j.cn115682-20230904-00874
- VernacularTitle:老年脊柱退行性疾病患者术前衰弱的危险因素及预测模型构建
- Author:
Mengxian OU
1
;
Jun WANG
;
Hongchao DUAN
;
Haiyang ZHANG
;
Huan LIU
;
Chunyuan LI
Author Information
1. 首都医科大学宣武医院神经外科，北京 100053
- Keywords:
Frailty;
Aged;
Spinal degenerative disease;
Surgery;
Risk prediction model
- From:
Chinese Journal of Modern Nursing
2024;30(27):3727-3732
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To screen for preoperative frailty risk factors in elderly patients with spinal degenerative diseases and construct a risk prediction model.Methods:From September 2021 to August 2022, convenience sampling was used to select 324 elderly patients who underwent spinal surgery in the Department of Neurosurgery at Xuanwu Hospital, Capital Medical University as research subjects. The patients were surveyed using the General Information Questionnaire, Barthel Index, Nutritional Risk Screening 2002, Mini-mental State Examination, Geriatric Depression Scale-15, Generalized Anxiety Disorde-7, Athens Insomnia Scale, Charlson Comorbidity Index (CCI), and Modified Frailty Index. Binary Logistic regression analysis was used to explore the influencing factors of preoperative frailty in elderly patients with spinal degenerative diseases and establish a risk prediction model. Receiver Operating Characteristic (ROC) curve was used to assess the discriminative power of the model, and Hosmer-Lemeshow test was used to evaluate the goodness of fit of the model.Results:A total of 324 questionnaires were distributed, and 308 valid questionnaires were collected, with a valid response rate of 95.06% (308/324). Among 308 elderly patients with degenerative spinal diseases, 56 patients experienced preoperative frailty. Binary Logistic regression analysis showed that falls within one year, CCI, serum albumin, activities of daily living, and self-rated health status were the influencing factors for preoperative frailty in elderly patients with spinal degenerative diseases ( P<0.05). The area under the ROC curve of the prediction model was 0.851, with a sensitivity of 0.786 and a specificity of 0.778. Hosmer Lemeshow test indicated that the predictive model had a good fit (χ 2=3.764, P=0.709) . Conclusions:Falls within one year, CCI, serum albumin, activities of daily living, and self-rated health status are influencing factors for preoperative frailty in elderly patients with spinal degenerative diseases. The risk prediction model constructed can identify preoperative frailty early and has good predictive performance, which is worthy of clinical promotion.
