Frailty and Related Factors in Elderly Patients with Chronic Pain
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摘要:
目的 了解老年慢性疼痛就诊者的衰弱情况及其相关影响因素。 方法 采用横断面简单随机抽样法对2023年1至6月在玉溪市人民医院疼痛科老年慢性疼痛就诊者进行面对面问卷调查,疼痛程度应用NIPRO Painvision(PS- 2100 )和视觉模拟评分(VAS)综合评价,抑郁、焦虑和衰弱情况调查分别采用贝克抑郁自评问卷(BDI)、贝克焦虑自评问卷(BAI)和FRAIL量表,Logistic回归分析老年慢性疼痛就诊者衰弱的相关因素。结果 272例老年慢性疼痛就诊者中,衰弱患病率为 21.32%(95%CI 16.46%~26.19%),衰弱组年龄中位数[69(65~72)岁]高于非衰弱组[66(62~69)岁],差异具有统计学意义(Z = 2.962,P = 0.003)。多因素Logistic 回归模型结果显示:老年慢性疼痛就诊者年龄越大衰弱风险越高(OR = 1.08,95%CI 1.02~1.14);重度疼痛者(OR = 3.12,95%CI 1.42~6.88)、疼痛部位>1 个者(OR = 4.47,95%CI 2.23~8.94)和抑郁者(OR = 4.76,95%CI 2.34~9.68)衰弱风险分别高于轻/中度疼痛者、仅有 1 个疼痛部位者和无抑郁者。 结论 玉溪市老年慢性疼痛就诊者有较高的衰弱患病率,年龄、疼痛程度、疼痛部位和抑郁状况与衰弱发生风险有关,建议定期进行衰弱筛查并及时干预治疗,提高老年人的生活质量。 Abstract:Objective To understand the frailty of elderly patients with chronic pain and its related influencing factors. Methods A face-to-face survey using a simple random sampling method was conducted for elderly patients with chronic pain at a grade-A tertiary hospital in Yuxi City from January to June 2023. The NIPRO Painvision (PS- 2100 ) and the Visual Analog Scale (VAS) were used for comprehensive pain assessment. The investigation of depression, anxiety, and frailty was conducted using the Beck Depression Inventory (BDI), the Beck Anxiety Inventory (BAI), and the FRAIL scale, respectively. Logistic regression analysis was performed to identify factors associated with frailty in elderly patients with chronic pain.Results Among the 272 elderly patients with chronic pain, the prevalence of frailty was 21.32% (95%CI 16.46%-26.19%). The median age of the frail group was [69 (65-72) years], which was higher than that of the non-frail group [66 (62-69) years], and this difference was statistically significant (Z = 2.962, P = 0.003). The results of the multivariate logistic regression model showed that older age was associated with a higher risk of frailty among elderly patients with chronic pain (OR = 1.08, 95%CI 1.02-1.14). Those with severe pain (OR = 3.12, 95%CI: 1.42-6.88), multiple pain locations (OR = 4.47, 95%CI 2.23-8.94), and those experiencing depression (OR = 4.76, 95%CI 2.34-9.68) had a significantly higher risk of frailty compared to those with mild/moderate pain, single pain location, and no depression. Conclusion In Yuxi City, elderly patients with chronic pain have a high prevalence of frailty. Factors such as age, pain intensity, pain location, and depression are associated with the risk of frailty. It is recommended to conduct regular frailty screenings and timely interventions to improve the quality of life for older adults. -
Key words:
- Elderly /
- Chronic pain /
- Frailty /
- Influencing factors
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表 1 老年慢性疼痛就诊者人口学特征和衰弱情况
Table 1. The demographic characteristics and the frailty among elderly patients with chronic pain
特征 n
(n = 272)衰弱 χ2 P n = 58 发生率(95%CI) 性别 0.016 0.899 女 91(33.46) 19 20.88(12.53~29.23) 男 181(66.54) 39 21.55(15.56~27.54) 民族 0.505 0.477 汉族 216(79.41) 48 22.22(16.68~27.77) 其他民族 56(20.59) 10 17.86(7.83~27.89) 文化程度 0.489 0.486 小学及以下 125(45.96) 29 23.20(15.80~30.60) 初中级以上 147(54.04) 29 19.73(13.29~26.16) 婚姻状况 0.570 0.450 未婚/离异/丧偶 101(37.13) 24 23.76(15.46~32.06) 已婚 171(62.87) 34 19.88(13.90~25.87) 职业 0.195 0.658 农民 205(75.37) 45 21.95(16.29~27.62) 非农 67(24.63) 13 19.40(9.93~28.87) 疼痛程度 7.865 0.005* 轻/中度 222(81.62) 40 18.02(12.96~23.07) 重度 50(18.38) 18 36.00(22.70~49.30) 疼痛部位数(个) 15.830 <0.001* 1 169(62.13) 23 13.61(8.44~18.78) ≥2 103(37.87) 35 33.98(24.83~43.13) 抑郁 15.830 <0.001* 否 169(62.13) 23 13.61(8.44~18.78) 是 103(37.87) 35 33.98(24.83~43.13) 焦虑 15.981 <0.001* 否 201(73.90) 31 15.42(10.43~20.42) 是 71(26.10) 27 38.03(26.74~49.32) 疼痛病程(a) 4.197 0.123 <1 167(61.40) 32 19.16(13.19~25.13) 1~2.9 51(18.75) 9 17.65(7.18~28.11) ≥3 54(19.85) 17 31.48(19.09~43.87) 疼痛类型 3.287 0.281 慢性神经病理性疼痛 34(12.50) 11 32.35(16.63~48.08) 慢性肌肉骨骼疼痛 88(32.35) 16 18.18(10.12~26.24) 慢性创伤和术后疼痛 86(31.62) 20 23.26(14.33~32.18) 其它疼痛 64(23.53) 11 17.19(7.94~26.43) *P < 0.05。 表 2 老年慢性疼痛就诊者衰弱的多因素分析
Table 2. Multivariate analysis of frailty in elderly patients with chronic pain
特征 β SE Wald χ2 OR(95%CI) P 年龄 0.075 0.030 6.235 1.08(1.02~1.14) 0.013 疼痛程度 轻/中度 1.00 重度 1.139 0.403 7.990 3.12(1.42~6.88) 0.005 疼痛部位 1 1.00 >1 1.497 0.354 17.905 4.47(2.23~8.94) <0.001 抑郁 否 1.00 是 1.560 0.362 18.551 4.76(2.34~9.68) <0.001 -
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