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Objective To investigate the diagnostic value of 4 novel inflammatory markers related to routine blood tests, namely neutrophil-to-lymphocyte ratio (NLR), red blood cell distribution width (RDW), hemoglobin-to-RDW ratio (HRR) and systemic immune-inflammation index (SII), in elderly patients with chronic cardiovascular disease (CVD) complicated with frailty. Methods Retrospectively analyze 110 patients with chronic stable CVD who were hospitalized in the cadre ward of cardiovascular medicine at the Air Force Characteristic Medical Center from January 2022 to June 2023. According to the assessment results of the Fried scale, they were divided into three groups: non-frailty group (Fried score=0, n=30), the pre-frailty group (Fried score 1 or 2, n=40) and frailty group (Fried score ≥3, n=40). The differences in general information, the impairment rate of daily living activities, miniature nutritional assessment-short form (MNA-SF) scores, mini-mental state examination (MMSE) scores, and the indicators such as NLR, RDW, HRR, and SII among the three groups were compared. Spearman rank correlation was used to analyze the correlation between NLR, RDW, HRR, SII and frailty scores as well as each frailty indicator. Multivariate logistic regression analysis was performed to identify the independent risk factors for frailty in elderly patients with chronic CVD, and the receiver operating characteristic (ROC) curve was used to assess the clinical diagnostic value of NLR and HRR in elderly patients with chronic CVD complicated with frailty. Results Compared with non-frailty group and pre-frailty group, patients in frailty group were older, with higher impaired rates of daily living activities, NLR, RDW, and SII, and lower MNA-SF scores, MMSE scores, and HRR, and differences were statistically significant (P<0.05). Spearman rank correlation analysis showed that the frailty score was positively correlated with NLR (rs=0.354, P<0.001), and RDW (rs=0.448, P<0.001), negatively correlated with HRR (rs=-0.232, P=0.024), and had no significant correlation with SII (rs=0.144,P=0.167). Further analysis of the correlation between the above novel inflammatory markers and the 5 components of frailty showed that NLR was positively correlated with fatigue (rs=0.228, P=0.017), slowed walking speed (rs=0.299, P<0.001), and low physical function(rs=0.319, P<0.001); RDW was positively correlated with decreased grip strength (rs=0.321, P<0.001), slowed walking speed (rs=0.422,P<0.001), and low physical function (rs=0.246, P=0.001); and HRR was negatively correlated with slowed walking speed (rs=-0.230, P=0.025), and low physical function (rs=-0.299, P=0.003). Multivariate logistic regression analysis showed that MNA-SF score (OR=0.577, 95%CI 0.342-0.973) was an independent protective factor for pre-frailty in elderly patients with chronic CVD (P<0.05); NLR (OR=7.866, 95%CI 1.101-56.185) was an independent risk factor for frailty, while HRR (OR=0.344, 95%CI 0.120-0.983) and MNA-SF score (OR=0.292, 95%CI 0.146-0.580) were independent protective factors for frailty in elderly CVD patients (P<0.05). The area under the ROC curve of NLR and HRR for diagnosing frailty in elderly patients with chronic CVD were 0.778 and 0.749, respectively. Conclusion NLR and HRR have high clinical diagnostic value for frailty in elderly patients with chronic CVD, and are expected to become effective inflammatory markers for screening elderly patients with chronic CVD complicated with frailty.
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| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |
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