老年急性心肌梗死住院患者营养相关参数与衰弱状态关联性研究OA

[Objective]To investigate the association between multidimensional nutrition-related parameters and frailty among older inpatients with acute myocardial infarction(AMI),and to develop a combined predic-tion model for early identification.[Method]A retrospective study was conducted in 396 hospitalized AMI patients aged≥65 years admitted to a hospital between January 2023 and December 2024.Frailty was assessed us-ing the Clinical Frailty Scale(CFS),and patients were divided into a non-frailty group(CFS 1-4)and a frailty group(CFS 5-9).General data,Nutritional Risk Screening 2002(NRS2002;nutritional risk defined as a score of≥3),stratified Activities of Daily Living(ADL),and nutrition-related biochemical indicators including 25-hydroxyvitamin D[25(OH)D]were compared between the two groups.Multivariable logistic regression was used to identify factors associated with frailty.A combined prediction model was established based on key variables,and its performance was assessed by receiver operating characteristic(ROC)analysis,calibration,decision curve analysis(DCA),and Bootstrap internal validation.[Result]Of the 396 older hospitalized patients with AMI,232 were frail,with a frailty prevalence of 58.6％.Multivariable analysis indicated that NRS2002-defined nutritional risk,lower ADL strata,and decreased 25(OH)D levels were significantly associ-ated with frailty(all P<0.05).The combined model based on ADL strata,NRS2002 nutritional risk,and 25(OH)D yielded an AUC of 0.919(95％CI:0.893-0.944),and the Bootstrap-corrected AUC was 0.914(95％CI:0.890-0.941).The model showed good calibration,and DCA demonstrated a favorable net clinical benefit over a threshold probability range of approximately 0.10-0.80.[Conclusion]Frailty is common in older hospitalized patients with AMI.NRS2002 nutritional risk,ADL strata,and 25(OH)D levels are significantly associated with frailty,highlighting the importance of nutritional risk screening,functional assessment,and vitamin D monitoring in early risk identification.The combined model showed good discrimination,calibration,and clinical applicability,and may provide a practical reference for early nutritional management and frailty intervention during hospitalization.