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COPD) mostly focus on the lung itself,while studies on the extrapulmonary manifestations of COPD are still lacking. Many
studies in China and at abroad have shown that COPD is closely related to geriatric syndrome,but it has not been further
confirmed. Objective To investigate the prevalence of COPD in senile inpatients in several hospitals in Yunnan Province in
the past three years,and to explore the influencing factors of elderly COPD from the aspect of geriatric syndrome. Methods A
total of 2 182 newly admitted elderly patients(≥ 60 years old) in several hospitals of Yunnan Province from September 2018
to June 2021 were selected as the research objects and divided into COPD group and non-COPD group according to whether the
patients had COPD. The software platform of "Comprehensive Geriatric Assessment System" independently developed by the
Geriatrics Department of the First People's Hospital of Yunnan Province was used to collect general data from the patients. At
the same time,the scales in the system were used to conduct a comprehensive geriatric evaluation of the patients,including the
assessment of anxiety and depression by 15-item geriatric depression scale(GDS-15),the assessment of insomnia situation
by athens insomnia scale(AIS),the assessment of family support by PAGAR scale,the assessment of fall risk by Morse fall
scale,the assessment of cognitive function by mini-mental state examination(MMSE),the assessment of nutrition status
by mini nutritional assessment scale,the assessment of the patients' daily living ability by the basic activities of daily living
(BADL) scale,the assessment of frailty state by the Fried Scale,the assessment of swallowing(choking) by swallowing
function assessment scale,the assessment of urinary incontinence by incontinence questionnaire simple form(ICI-Q-SF),the
assessment of constipation by Roma Ⅲ scale,the assessment of pain by visual analogue scale(VAS). The influencing factors of
COPD in the elderly hospitalized patients were analyzed by binary Logistic regression. Results There were 1 558 cases(71.4%)
in the non-COPD group and 624 cases(28.6%) in the COPD group. The results of binary Logistic regression analysis showed
that age ≥ 75 and <85 years,age ≥ 85 years old,male,anxiety and depression,potential malnutrition,malnutrition,pre-
frailty,frailty were independent influencing factors of COPD(P<0.05). Conclusion Elderly hospitalized patients aged ≥ 60
years have a higher prevalence of COPD and are closely associated with geriatric syndrome.
【Key words】 Pulmonary disease,chronic obstructive;Geriatric syndrome;Aged;Inpatients;Root cause analysis
第七次人口普查结果显示,云南省老年(≥ 60 岁)
本研究创新点:
人口为 7 038 030 人,占总人口的 14.91%,与 2010 年
(1)采用移动软件平台替代传统纸质版评估方
第六次人口普查相比,≥ 60 岁人口占比上升了 3.84%。
式对老年综合征及相关症状进行评估,明显减少了数
慢性阻塞性肺疾病(以下简称慢阻肺)是老年人常见病
据收集及统计上的误差,增加了数据可靠性。(2)
之一,随着老年人口比例上升,慢阻肺患者数量亦日益
样本量较大(2 182 例),且为多中心研究,具有较
增加。慢阻肺是一种以气流受限和呼吸困难为特征的肺 好的代表性。(3)主要从老年医学核心技术(老年
部疾病,是全球发病率和死亡率较高的疾病之一 [1] 。
综合征)研究慢性阻塞性肺疾病(以下简称慢阻肺)
目前国内关于慢阻肺的研究多为小样本、单中心研究,
的影响因素,弥补了国内对慢阻肺肺外表现研究相对
且多着重于肺部病变,对肺外表现及相关合并症尚未引
较少的不足。
起足够重视。既往研究显示,慢阻肺与多种老年综合征 本研究局限性:
密切相关,但尚未得到进一步证实 [2] 。
(1)此次研究为横断面研究,不能直接探讨慢
老年综合征是老年医学的三大核心之一,是指衰老、
阻肺与影响因素之间的因果关系。(2)样本大多来
疾病、心理及社会环境等因素导致老年人出现日常生活
源于三级医院且为老年(≥ 60 岁)住院患者,不能
能力受损、生活质量下降和预期寿命缩短的非特异性症
代表整个老年群体。(3)未能对慢阻肺的严重程度
状和体征,如:日常活动功能障碍、营养不良、认知障 进行分级,因此,在今后的研究中还需进一步探讨。
碍、焦虑抑郁、衰弱、多病共存、多重用药等 [3] 。本
研究旨在调查老年(≥ 60 岁)慢阻肺的患病现状,并 养老机构,各级医院所收患者数据均可与云南省第一人
从老年综合征角度研究老年慢阻肺的影响因素,以期为 民医院老年医学科共享。本研究的患者数据主要来源于
今后老年慢阻肺的早期筛查及综合治疗奠定基础。 昆明市、曲靖市、昭通市、红河州、普洱市、保山市、
1 对象与方法 大理州、临沧市、玉溪市等。从该系统中导出 2018 年
1.1 研究对象 “老年综合评估(CGA)系统”软件 9 月—2021 年 6 月共 4 000 余例患者的 CGA 结果数据
由云南省第一人民医院老年医学科自主研发,于 2018 (含一般资料及慢性病情况),去除与本研究目的无关、
年建成使用,现已通过签订合同方式免费覆盖云南省 存在明显疾病干扰及不完整数据后共纳入 2 182 例患者
64 家医疗机构,含省、州、市、县、社区各级医院及 的有效数据。纳入标准:(1)新入院老年患者,年龄