老年膝关节置换患者术前衰弱现状及影响因素*

张晶; 常红; 束娇娇; 阿依沙·吉力力; 帕丽达·买买提

doi:10.3969/j.issn.1674-7593.2026.03.012

国际老年医学杂志 ›› 2026, Vol. 47 ›› Issue (3) : 335 -340. DOI: 10.3969/j.issn.1674-7593.2026.03.012

论著

老年膝关节置换患者术前衰弱现状及影响因素^*

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作者信息 +

Preoperative frailty status and its influencing factors among elderly patients undergoing knee arthroplasty

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文章历史 +

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摘要

目的调查老年膝关节置换患者术前衰弱现状及其影响因素。方法采用便利抽样法,选取2024年7月—11月新疆医科大学第四附属医院关节外科收治的拟行膝关节置换手术的289例老年患者作为研究对象。使用一般资料调查表、中文版Tilburg衰弱量表、Barthel指数评定量表、营养风险筛查量表2002、医院焦虑抑郁量表、社会支持量表进行评估。通过χ²检验进行单因素分析,采用二元logistic回归分析老年膝关节置换患者术前衰弱的影响因素。结果共发放问卷289份,共回收有效问卷281份,其中93例发生术前衰弱(33.10%)。二元logistic回归分析显示:年龄70～79岁(OR=2.130,95%CI:1.134~4.001)、女性(OR=3.157,95%CI:1.395~7.144)、多重用药(OR=4.185,95%CI:2.283~7.672)、营养状态(OR=3.581,95%CI:1.784~7.190)及焦虑状况(OR=3.170,95%CI:1.507~6.666)是老年膝关节置换患者术前衰弱的影响因素(P<0.05)。结论老年膝关节置换患者术前衰弱发生率较高,年龄大、女性、多重用药、营养状态差、焦虑的老年膝关节置换患者术前更易发生衰弱。医护人员应强化老年膝关节置换患者术前衰弱评估,针对高风险人群实施个体化干预,以预防或延缓术前衰弱发生,提升围手术期安全与预后效果。

Abstract

Objective To investigate the preoperative frailty status and its influencing factors in elderly patients undergoing knee replacement surgery. Methods A total of 289 elderly scheduled for knee arthroplasty in the department of joint surgery at the Fourth Affiliated Hospital of Xinjiang Medical University were recruited by convenience sampling method between July and November 2024. Data were collected using a general information questionnaire, the Chinese-language version of the Tilburg Frailty Indicator, the Barthel Index for activities of daily living, the Nutritional Risk Screening 2002, the Hospital Anxiety and Depression Scale, and the Social Support Rating Scale. Univariate analysis was performed using the χ² test, and binary logistic regression analysis was employed to identify factors associated with preoperative frailty in these patients. Results A total of 289 questionnaires were distributed in this study, and 281 valid questionnaires were collected, among them, 93 cases (33.10%) experienced preoperative frailty. Binary logistic regression analysis indicated that age from 70 to 79(OR = 2.130, 95% CI: 1.134-4.001), female gender (OR = 3.157, 95% CI: 1.395-7.144), polypharmacy (OR = 4.185, 95% CI: 2.283-7.672), nutritional status (OR = 3.581, 95% CI: 1.784-7.190), and anxiety (OR = 3.170, 95% CI: 1.507-6.666) were the influencing factors for preoperative frailty in elderly patients undergoing knee replacement (P<0.05). Conclusion The prevalence of preoperative frailty is relatively high among elderly patients undergoing knee arthroplasty. Patients who are older, female, take multiple medications, have poor nutritional status, or experience anxiety are more likely to be frail preoperatively. Healthcare providers should strengthen frailty assessment before surgery and implement individualized interventions for high-risk patients to prevent or delay frailty and improve perioperative safety and recovery outcomes.