老年患者卧床不起的危险因素分析

目的探索老年人卧床不起的危险因素。方法应用病例对照研究方法，对卧床不起和非卧床不起老年患者各121例，采用自制结构式问卷进行躯体、心理和社会因素调查。结果脑卒中、晚期恶性肿瘤、器官功能衰竭、高龄、老年性痴呆等疾病的相对危险度（OR值）分别为4．94、1．72、8．34、5．65、11．99。老年卧床不起患者抑郁（12．3）、焦虑评分（47．0）明显高于对照组（7．5和40．1，P=0．00）；生活满意度评分（11．2）明显低于对照组（13．8，P=0．00）；社会支持总分（38．4）、主观支持评分（20．7）和支持利用度评分（7．6）明显低于对照组（分别为42．7、23．2和8．4，P〈0．01），而客观支持评分两组无差异（分别为10．1及11．1，P〉0．05）。结论脑卒中、晚期恶性肿瘤、器官功能衰竭、高龄、老年性痴呆等是导致老年人卧床不起主要的躯体危险因素；抑郁、焦虑是老年卧床不起的心理危险因素；社会支持水平低下是老年卧床不起的社会危险因素。

An analysis on risk factors for the bedridden elderly patients

Objective To explore the risk factors for the bedridden elderly patients. Methods By case-control study, 121 bedridden and 121 non-bedridden elderly patients were assessed by self-designed structural questionnaire. Results Odds ratio (OR) of stroke, advanced stage of malignancy, organ function failure, advanced age, and senile dementia were 4. 94, 1. 72, 8. 34, 5. 65 and 11. 99, respectively. The total mean scores of the geriatric depression and self-rating anxiety scale in bedridden elderly patients were 12. 3 and 47. 0, which were higher than those in control(7. 5 and 40. 1, respectively, P=0. 00). The total mean score of life satisfaction index A was 11.2, which was obviously lower than that of control(13. 8, P = 0. 00). The scores of total social support, subjective social support and utilization of social support were 38.4, 20.7 and 7. 6, respectively, which were obviously lower than those of control group (42. 7, 23.2 and 8.4, respectively, P<0. 01). Conclusions Stroke, advanced stage of malignancy, organ function failure, advanced age, and senile dementia are frequent physical risk factors of the bedridden elderly patients. Depression and anxiety are the mental risk factors and low level of social support are the social risk factors.