Analysis of the current status and influencing factors of frailty in hospitalized elderly patients with atrial fibrillation

Ma Weiqin; Pan Dong; Shi Qian; Guo Zhenbang; Wu Jianjun; Li Lin

doi:10.3760/j.issn.1673-4777.2025.06.002

Abstract：Objective To investigate the current status and influencing factors of frailty in hospitalized elderly patients with atrial fibrillation.Methods A total of 106 elderly inpatients with atrial fibrillation diagnosed and treated in Bazhong Central Hospital,Sichuan Province from May 2021 to May 2024 were collected as the research objects,and their clinical data were recorded.According to the occurrence of frailty,they were divided into non-frailty group(56 cases)and frailty group(50 cases).Multivariate Logistic regression analysis was used to screen the influencing factors of frailty in hospitalized elderly patients with atrial fibrillation.And construct a nomogram prediction model.The Bootstrap method was used for internal verification,the Hosmer-Lemeshow test was used to analyze the consistency of the nomogram prediction model,the receiver operating characteristic(ROC)curve was drawn to analyze the discrimination of the model,and the calibration curve was used to analyze the calibration of the model.Results Among 106 hospitalized elderly patients with atrial fibrillation,50 patients developed frailty,with an incidence of 47.2％.The 30-day and 90-day readmission rates in the frailty group were higher than those in the non-frailty group[14.0％(7/50)vs 1.8％(1/56),20.0％(10/50)vs 5.4％(3/56)](both P＜0.05).The age and the proportion of Barthel index score＜60 in the frailty group were greater/higher than those in the non-frailty group,and the hemoglobin and albumin were lower than those in the non-frail group(all P＜0.05).Increasing age and Barthel index score＜60 were independent risk factors for frailty in hospitalized elderly patients with atrial fibrillation,and increasing hemoglobin and albumin were protective factors for frailty in hospitalized elderly patients with atrial fibrillation(all P＜0.05).The Hosmer-Lemeshow test results of internal validation of the nomogram showed x2=5.983,P=0.649.The ROC curve results showed that the area under the curve was 0.864(95％confidence interval:0.794-0.934).The calibration curve results showed that the actual probability was basically consistent with the predicted probability,and the slope of the curve was close to 1.Conclusion The incidence of frailty in hospitalized elderly patients with atrial fibrillation is high.Patients with older age,Barthel index score＜60,lower hemoglobin and lower albumin are more likely to have frailty.