Frailty evaluation and associated factors for oldest-old male inpatients with comorbidities: A cross-sectional study

  Background  Frailty refers to the non-specific state that the decline of physiological reserves of the elderly leads to the increase of vulnerability and the decline of anti-stress ability. The risk of adverse events such as falls, infection, prolonged hospitalization and death in the elderly patients with frailty increases during hospitalization.

  Objective  To evaluate the frail state of elderly male inpatients and explore its related factors.

  Methods  Clinical data about male patients aged ≥ 80 years who were continuously hospitalized in the Department of Geriatrics of Chinese PLA General Hospital from January 2019 to January 2020 were collected. They were divided into frail group and non-frail group based on the evaluation by Fried Frailty Phenotype Scale. Univariate and multivariate logistic regression analyses of risk factors related with frailty were conducted.

  Results  Totally 133 elderly patients were included with an average age of (90.22 ± 5.37) years and a median of 2 (2, 3) kinds of elderly chronic diseases. There were 77 (57.89%) patients in the frail group and 56 (42.11%) patients in the non-frail group according to the Fried Frailty Phenotype Scale. Univariate analysis showed that age, total iron binding capacity (TIBC), and the risks of moderate-severe anemia, chronic lung disease, and cancer in the frail group were significantly higher than those in the non-frail group (all P＜0.05), and the rate of moderate-severe anemia was as high as 81.5%. Multivariate logistic regression analysis showed that older age (OR=1.151, 95% CI: 1.052-1.260), high TIBC level (OR=1.038, 95% CI: 1.003-1.074), and moderate-severe anemia (OR=5.975, 95% CI: 1.112-32.093) were associated with frailty (all P＜0.05); multiplicative interaction was found between moderate-severe anemia and TIBC (P＜0.05). Based on the multivariate logistic regression model, the receiver operating characteristic curve (ROC) was constructed, and the area under the curve (AUC) of the combination of moderate-severe anemia, TIBC level and age was 0.820, higher than that of anemia (AUC=0.597) and TIBC (AUC=0.619).

  Conclusion  Advanced age, moderate-severe anemia, and increased TIBC are closely related to comorbidities and frailty in elderly males. Early and effective intervention will help to prevent and control the development of frailty.