Frailty Status Trajectory (T1–T3).

Frailty is a common multifactorial clinical syndrome in older patients that seriously affects their prognosis. However, most studies to date have ignored the dynamics of frailty. Therefore, we employed a one-month observational longitudinal study to explore frailty trajectories using a latent class growth model. In total, 155 older patients who underwent abdominal surgery involving the digestive system were assessed preoperatively, at discharge, and at the one-month follow-up, and multiple logistic regression analysis was conducted to identify factors influencing frailty trajectories. Four frailty trajectory patterns were identified: no frailty (13.5%), frailty exacerbation (40.0%), frailty improvement (20.0%), and persistent frailty (26.5%). Logistic regression analysis revealed that body mass index, the Charlson comorbidity index score, the type of surgery, the intraoperative drainage tube retention time (drainage time), the first time the patient got out of bed after surgery, the time of the first oral feed after surgery, postoperative complications, mobility, nutritional risk, and anxiety were associated with frailty trajectories. We identified four frailty trajectories in older patients undergoing abdominal surgery involving the digestive system and found that these trajectories were influenced by multiple factors. Focusing on individual specificity is conducive to accurately addressing frailty-associated clinical problems and guiding relevant nursing decisions.衰弱（Frailty）是老年患者中常见的多因素临床综合征，可严重影响患者预后。然而，迄今为止绝大多数研究均忽略了衰弱的动态变化特征。为此，本研究开展了一项为期1个月的观察性纵向研究，采用潜在类别增长模型（latent class growth model）探究衰弱轨迹。本研究共纳入155例接受消化系统腹部手术的老年患者，分别于术前、出院时及术后1个月随访时点对其衰弱状态进行评估，并开展多重logistic回归分析以明确影响衰弱轨迹的相关因素。最终确定了4种衰弱轨迹模式：无衰弱型（占比13.5%）、衰弱恶化型（40.0%）、衰弱改善型（20.0%）以及持续性衰弱型（26.5%）。多重logistic回归分析结果显示，身体质量指数、查尔森合并症指数（Charlson comorbidity index）评分、手术类型、术中引流管留置时长（简称引流时长）、术后首次下床活动时间、术后首次经口进食时间、术后并发症、活动能力、营养风险及焦虑情绪均与衰弱轨迹存在显著关联。本研究明确了接受消化系统腹部手术的老年患者存在4种衰弱轨迹模式，且此类轨迹受多种因素共同影响。关注患者的个体特异性，有助于精准解决与衰弱相关的临床问题，并为相关护理决策提供指导。