【摘要】 目的 构建老年晚期慢性阻塞性肺疾病（简称慢阻肺）患者6个月死亡风险预测量表，为老年晚期慢阻肺患者生存期预测工具开发提供理论依据。方法 采用文献研究法，筛选提取老年晚期慢阻肺患者6个月内死亡风险相关因素，形成量表初始条目池；设计函询问卷，采用德尔菲法对17名专家进行两轮函询，依据条目重要性算术平均值、变异系数及满分频率综合筛选条目，确定最终量表。结果 两轮专家函询问卷的有效回收率分别为94.12%和100.00%，专家权威系数均≥0.90（分别为0.93、0.90），肯德尔和谐系数分别为0.28和0.26（均P<0.05），表明专家意见协调性与权威性良好，函询结果可靠。最终构建的老年晚期慢阻肺患者短期死亡风险预测量表包括10个一级条目、55个二级条目。10个一级条目分别是人口学特征、预后预测、疾病病程情况、并发症、共病情况、老年综合征、体征/症状、慢阻肺症状评分、检查/检验指标、慢阻肺治疗情况。结论 基于德尔菲法构建的老年晚期慢阻肺患者6个月死亡风险预测量表可靠、客观，有助于预测老年晚期慢阻肺生存期。更多还原

【Abstract】 Objective To develop a risk prediction scale for 6-month mortality in elderly patients with advanced chronic obstructive pulmonary disease(COPD), and provide a theoretical basis for creating tools to predict survival in this patient population. Methods A literature review was conducted to identify and extract risk factors associated with6-month mortality in elderly patients with advanced COPD, forming the initial item pool for the scale. A Delphi method was employed, involving two rounds of correspondence with 17 multidisciplinary experts through a designed questionnaire. Items were comprehensively screened based on the arithmetic mean of item importance, coefficient of variation, and full score frequency to determine the final scale. Results The effective response rates for the two rounds of expert correspondence were 94.12% and 100.00%, respectively. The expert authority coefficients were both ≥0.90(0.93 and 0.90, respectively). The Kendall’s coefficients of concordance were 0.28 and 0.26(both P<0.05), indicating good coordination and authority among the experts and reliable results from the correspondence. The final constructed risk prediction scale for short-term mortality in elderly patients with advanced COPD includes 10 primary items and 55 secondary items. The 10 primary items are as follows: demographic characteristics, prognostic prediction, disease course,complications, comorbidity status, geriatric syndromes, signs/symptoms, COPD symptom scores, examination/laboratory indicators, and COPD treatment. Conclusions The Delphi-based risk prediction scale for 6-month mortality in elderly patients with advanced COPD is reliable and objective, and is expected to be a valuable tool to predict survival in this patient population.更多还原