Effects of comprehensive evaluation of frailty and corresponding intensive education on health outcomes of elderly patients with cardiovascular disease
Received:March 22, 2020  
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DOI:10.11915/j.issn.1671-5403.2021.01.002
Key words:aged  cardiovascular disease  frailty  geriatric assessment  education This work was supported by National Key R&D Program of China
Author NameAffiliationE-mail
CHEN Yue-Ying Nursing Department,Beijing 100853, China  
YANG Rui Department of Vascular Surgery,  
CAO Wen-Zhe Institute of Geriatrics, Second Medical Center of Chinese PLA General Hospital, Beijing 100853, China  
HOU Hui-Ru Nursing Department,Beijing 100853, China hhr610626@163.com 
DONG Wei Department of Cardiology, First Medical Center of Chinese PLA General Hospital, Beijing 100853, China 301dongw@sina.comeffects 
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Abstract:
      Objective To investigate effects of comprehensive evaluation of frailty and corresponding intensive education on the health outcomes in the elderly patients with cardiovascular disease during hospitalization and after discharge. Methods A total of 100 consecutive elderly patients with cardiovascular disease were selected for the study, who were admitted to the Department of Cardiology of Chinese PLA General Hospital from February to September 2019. Fried frailty phenotype and comprehensive evaluation of the elderly were analyzed. Intensive education was conducted from multiple time points, and the efficacy was observed. Results Of all the included patients, 24 had frailty and 76 did not. Logistic regression analysis of the factors affecting frailty showed that 3-meter timed up & go test (OR=1.151,95%CI 1.029-1.288, P=0.014),angina (OR=8.510,95%CI 1.753-41.307, P=0.008) and D-dimer (OR=2.925, 95%CI 1.161-7.369, P=0.023) were risk factors of frailty. Our study showed that frailty had no effect on the complications in patients hospitalized with cardiovascular disease, and no adverse events such as death, falls, or fractures occurred in all patients. The incidence of falls, fractures and readmission within 6 months after discharge occurred in 9 frailty patients and 19 non-frailty patients without significant difference. The scores of depression assessment at 3 months after discharge in both groups were lower than that on hospitalization, and the number of long-term oral medicines was lower than that during hospitalization in the non-frailty group (P<0.05). The FRAIL score and BMI in the non-frail group decreased at 6 months after discharge compared with that during hospitalization (P<0.05), and the frailty group did not change significantly. There was no significant difference between the two groups in basic activities of daily living (BADL) score (P>0.05). Conclusion Comprehensive evaluation of frailty and corresponding intensive education in the elderly inpatients with cardiovascular disease contribute significantly to the reduction in the incidence of adverse events after hospitalization and discharge, which has more significant effects on modifying frailty, depression, body mass index and multiple medication in the non-frailty group than in the frailty group.
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