Study on the frailty-related serum markers in elderly patients with cerebral infarction / 中华老年医学杂志

ABSTRACT

Objective To investigate the frailty-related serum markers in elderly patients with cerebral infarction and to determine their diagnostic value for frailty. Methods A hundred and fourteen inpatients aged 65 years and over were continuously recruited from department of geriatrics. Participants were assigned into a frailty group and a non-frailty group according to the Fried Frailty Criteria. The frailty group was further divided into mild ,moderate ,and severe feeble groups according to the clinical frailty scales.We analyzed the differences in serum indexes ,the prevalence and incidence of chronic complications and geriatric syndrome between the frailty group and non-frailty group. The ROC curves of frailty-related serum indexes were drawn and the optimal cut-off points were determined. Finally ,the area under ROC curves were calculated and compared. Results A total of 114 elderly patients with cerebral infarction were divided into a frailty group (78/114 ,68.4%)and a non-frailty group (36/114 ,31.6%).Seventy-eight patients (68.4%)in the frailty group had senile cerebral infarction. The prevalence of cerebral infarction combined with hypertension (88.5%) ,angina (53.8%) ,myocardial infarction (32.1%) ,heart failure (34.6%) ,chronic renal disease (28.2%) ,and malignant tumor (24.4%)was significantly higher in the frailty group than in the non-frailty group (69.4%,27.8%,8.3%,13.9%,11.1%,and 8.3%,respectively ;χ2＝ 6.158 ,6.747 ,7.478 ,5.241 , 4.088 ,4.062 ;all P＜0.05). The incidences of malnutrition and falling were significantly higher in the frailty group[28.2%(22/78)and 29.5%(23/78)]than in the non-frailty group[0.0%(0/36)and 2.8%(1/36) ,χ2＝12.582 ,10.572 ;all P＜0.05].Comparing the frailty with the non-frailty group ,the lower serum levels were found in HGB [(115.1 ± 19.7 )g/L vs. (135.8 ± 11.7 )g/L ] ,in LDL-C [(2.5 ± 0.9)mmol/L vs.(3.1± 0.7)mmol/L]and in ALB[(35.3 ± 4.3)g/L vs. (37.9 ± 2.3)g/L](t ＝－4.918 ,－2.536 ,－3.036 ;P＜0.05) ,while the higher serum levels were found in hs-CRP[(10.8 ± 14.3)mg/L vs.(3.1±2.9)mg/L],inD-Dimer[(494.2±412.9)μg/L ,vs.(256.4±221.5)μg/L],and in BNP[(458.0 ± 324.4)ng/L vs. (88.3 ± 68.4)ng/L](t ＝ 3.266 ,2.735 ,6.838 ;all P ＜ 0.05) . Furthermore ,the area under ROC curves of HGB , LDL-C and BNP were more than 0.75. Conclusions Serological markers related to frailty in elderly patients with cerebral infarction are HGB ,LDL-C ,ALB ,hs-CRP ,D-Dimer ,and BNP ,among which the diagnostic values of HGB , LDL-C and BNP are higher.