【摘要】 目的 探讨衰弱对老年慢性阻塞性肺疾病急性加重期（acute exacerbation of chronic obstructive pulmonary disease,AECOPD）患者院内死亡的影响。方法 选取2022年6月至2022年12月某大型三甲医院AECOPD老年住院患者，通过多元Logistic回归分析确定包括衰弱状态在内的独立预后因素，采用中介效应分析评估C反应蛋白（C-reactive protein,CRP）和白蛋白与院内死亡之间的介导关系。结果 共纳入1 356例患者（年龄为86.7±6.6岁），其中25.0%患者被诊断为衰弱。通过多元Logistic回归分析发现：衰弱、平均动脉压、查尔森共病指数、中性粒细胞-淋巴细胞比率、白细胞介素6、CRP、白蛋白和肌钙蛋白T与AECOPD患者院内死亡存在相关。此外，CRP和白蛋白在衰弱与院内死亡之间的关联中发挥了中介作用。结论 衰弱可能是老年AECOPD患者的不良预后因素。CRP和白蛋白可能介导了衰弱与院内死亡之间的作用机制。更多还原

【Abstract】 Objective To explore the association between frailty and in-hospital mortality in older patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD). Methods Elderly patients who were hospitalized with AECOPD from June 2022 to December 2022 at a large tertiary hospital were selected. The independent prognostic factors including frailty status were determined by multivariate logistic regression analysis. Mediation effect analysis was used to evaluate the mediating relationships between C-reactive protein(CRP) and albumin and in-hospital death. Results The training set included 1 356 patients(aged 86.7±6.6), 25.0% of whom were diagnosed with frailty. The multiple logistic regression analysis showed that frailty, mean arterial pressure, Charlson comorbidity index,neutrophil–lymphocyte ratio, interleukin-6, CRP, albumin, and troponin T were associated with in-hospital mortality. Furthermore, CRP and albumin mediated the associations between frailty and in-hospital mortality. Conclusion Frailty may be an adverse prognostic factor for older patients admitted with an AECOPD. CRP and albumin may be parts of mechanism between frailty and in-hospital death.更多还原