Study on the current status and influencing factors of oral frailty in older patients with colostomy_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

CHEN Yingjuan ,  XIN Xueling , SUN Feng

Department of Gastrointestinal Surgery, Affiliated Provincial Hospital of Shandong First Medical University, Jinan 250021, P. R. China;

Corresponding?author：

XIN Xueling, Email: 174190668@qq.com

Keywords：

colostomy; older patient; oral frailty; influence factor

DOI：

10.7507/1007-9424.202506112

Video：

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Objective To understand the current status of oral frailty in older patients with colostomy, and analyze the factors affecting oral frailty. Methods Retrospective analysis of older patients with colostomy who visited the gastroenterology outpatient department of Affiliated Provincial Hospital of Shandong First Medical University from May 2023 to December 2023 as research subjects. The questionnaire survey was conducted using the general data questionnaire, oral frailty index-8 (OFI-8), the edmonton frail scale (EFS), and the nutritional risk screening score 2002. According to the OFI-8 score, the patients were divided into oral frailty group and non-oral frailty group, and the two-classified logistic regression model was used for multi-factor analysis to explore the factors affecting the oral frailty of older patients. Results A total of 283 survey subjects were collected, and the incidence of oral frailty in older patients was 66.4% (188/283). Multi-factor analysis results show that old age [OR=1.181, 95% CI(1.015, 1.373), P=0.032], history of smoking [OR=2.721, 95%CI(1.122, 6.599), P=0.027], history of alcohol [OR=2.878, 95%CI(1.185, 6.991), P=0.020], dentures [OR=3.173, 95%CI(1.297, 7.759), P=0.011], postoperative oral diseases≥2 [OR=5.802, 95%CI(1.911, 17.615), P=0.002], nutritional risk [OR=2.744, 95%CI(1.033, 7.284), P=0.043], high EFS score [OR=1.823, 95% CI(1.309, 2.538), P<0.001], the type of stoma is permanent [OR=2.659, 95%CI(1.126, 6.275), P=0.026] is a risk factor for oral frailty in older patients with colostomy. Conclusion The incidence of oral frailty in older patients with colostomy is relatively high. We should pay more attention to the patient's oral frailty, and implement precise intervention measures for high-risk factors to prevent the occurrence of oral frailty or improve the condition of oral frailty.

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2.	褚卡, 王飛. 直腸癌腸造口患者術后衰弱發生現狀及其影響因素分析. 浙江創傷外科, 2023, 28(4): 647-650.
3.	張亞娟, 張偉英, 李丹, 等. 老年結直腸癌腸造口病人術后早期衰弱發生現狀及影響因素. 護理研究, 2022, 36(12): 2145-2150.
4.	Clegg A, Young J, Iliffe S, et al. Frailty in elderly people. Lancet, 2013, 381(9868): 752-762.
5.	Dibello V, Zupo R, Sardone R, et al. Oral frailty and its determinants in older age: a systematic review. Lancet Healthy Longev, 2021, 2(8): e507-e520. doi: 10.1016/S2666-7568(21)00143-4.
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10.	中華人民共和國國家衛生健康委員會醫政醫管局, 中華醫學會腫瘤學分會. 中國結直腸癌診療規范 (2020年版). 中國實用外科雜志, 2020, 40(6): 601-625.
11.	Tanaka T, Hirano H, Ohara Y, et al. Oral Frailty Index-8 in the risk assessment of new-onset oral frailty and functional disability among community-dwelling older adults. Arch Gerontol Geriatr, 2021, 94: 104340. doi: 10.1016/j.archger.2021.104340.
12.	陳宗梅, 譚瑩, 梁遠俊, 等. 老年人口腔衰弱篩查量表的漢化及信效度檢驗. 護理研究, 2023, 37(21): 3808-3812.
13.	Rolfson DB, Majumdar SR, Tsuyuki RT, et al. Validity and reliability of the Edmonton Frail Scale. Age Ageing, 2006, 35(5): 526-529.
14.	葛曉紅, 高麗紅. 埃德蒙頓衰弱量表的漢化及信效度檢驗. 中國實用護理雜志, 2021, 37(5): 352-358.
15.	Kondrup J, Allison SP, Elia M, et al. ESPEN guidelines for nutrition screening 2002. Clin Nutr, 2003, 22(4): 415-421.
16.	林穎敏. 老年住院患者營養風險篩查及營養支持的應用. 山東大學, 2015.
17.	Okunogbe A, Nugent R, Spencer G, et al. Economic impacts of overweight and obesity: current and future estimates for 161 countries. BMJ Glob Health, 2022, 7(9): e009773. doi: 10.1136/bmjgh-2022-009773.
18.	蔡明, 勵超, 熊振, 等. 預防性回腸造口還納技巧. 中華胃腸外科雜志, 2022, 25(11): 976-980.
19.	李易, 張紫嫣, 鄒炎鈴, 等. 住院癌癥患者口腔衰弱現狀及影響因素分析. 護理學雜志, 2024, 39(3): 49-52.
20.	韋靖怡, 趙秋艷, 黃維, 等. 養老機構老年人口腔衰弱發生情況及影響因素分析. 四川大學學報 (醫學版), 2024, 55(4): 947-957.
21.	Castrejón-Pérez RC, Wanyonyi KL, García-Vázquez PE, et al. Frailty index and ten oral conditions in the Coyoacan cohort study: a cross-sectional analysis. Gerodontology, 2023, 40(3): 372-381.
22.	康靜, 蔣運蘭, 李滔, 等. 老年人口腔衰弱影響因素的Meta分析和系統評價. 數理醫藥學雜志, 2025, 38(2): 121-132.
23.	Liu Q, Zhao M, Chen W, et al. Mainstream cigarette smoke induces autophagy and promotes apoptosis in oral mucosal epithelial cells. Arch Oral Biol, 2020, 111: 104646. doi: 10.1016/j.archoralbio.2019.104646.
24.	王敏, 楊文娟, 廖婷, 等. 社區老年人口腔衰弱風險預測模型的構建及驗證. 中華護理雜志, 2025, 60(3): 274-280.
25.	李寧寧, 田苗苗, 揣新慧, 等. 老年人口腔健康素養、營養狀況與口腔衰弱的關系. 牡丹江醫科大學學報, 2025, 46(1): 82-86.
26.	Kim DH, Rockwood K. Frailty in older adults. N Engl J Med, 2024, 391(6): 538-548.
27.	趙薇, 戴夢萍, 郜司蓉, 等. 社區老年人多維度衰弱現狀及影響因素研究. 中國老年保健醫學, 2024, 22(2): 76-80.
28.	吳敏, 劉芮, 許采頡, 等. 老年慢性病共病患者口腔衰弱的潛在剖面分析及影響因素研究. 中華護理雜志, 2025, 60(15): 1804-1810.
29.	Otálora-Otálora BA, López-Rivera JJ, Aristizábal-Guzmán C, et al. Host transcriptional regulatory genes and microbiome networks crosstalk through immune receptors establishing normal and tumor multiomics metafirm of the oral-gut-lung axis. Int J Mol Sci, 2023, 24(23): 16638. doi: 10.3390/ijms242316638.

1. 姚一菲, 孫可欣, 鄭榮壽. 《2022全球癌癥統計報告》解讀: 中國與全球對比. 中國普外基礎與臨床雜志, 2024, 31(7): 769-780.
2. 褚卡, 王飛. 直腸癌腸造口患者術后衰弱發生現狀及其影響因素分析. 浙江創傷外科, 2023, 28(4): 647-650.
3. 張亞娟, 張偉英, 李丹, 等. 老年結直腸癌腸造口病人術后早期衰弱發生現狀及影響因素. 護理研究, 2022, 36(12): 2145-2150.
4. Clegg A, Young J, Iliffe S, et al. Frailty in elderly people. Lancet, 2013, 381(9868): 752-762.
5. Dibello V, Zupo R, Sardone R, et al. Oral frailty and its determinants in older age: a systematic review. Lancet Healthy Longev, 2021, 2(8): e507-e520. doi: 10.1016/S2666-7568(21)00143-4.
6. de Sire A, Ferrillo M, Lippi L, et al. Sarcopenic dysphagia, malnutrition, and oral frailty in elderly: a comprehensive review. Nutrients, 2022, 14(5): 982. doi: 10.3390/nu14050982.
7. Abbas M, Ga?a N, Buchs NC, et al. Changes in the gut bacterial communities in colon cancer surgery patients: an observational study. Gut Pathog, 2022, 14(1): 2. doi: 10.1186/s13099-021-00477-7.
8. Kunath BJ, De Rudder C, Laczny CC, et al. The oral-gut microbiome axis in health and disease. Nat Rev Microbiol, 2024, 22(12): 791-805.
9. Luo S, Li W, Li Q, et al. Causal effects of gut microbiota on the risk of periodontitis: a two-sample Mendelian randomization study. Front Cell Infect Microbiol, 2023, 13: 1160993. doi: 10.3389/fcimb.2023.1160993.
10. 中華人民共和國國家衛生健康委員會醫政醫管局, 中華醫學會腫瘤學分會. 中國結直腸癌診療規范 (2020年版). 中國實用外科雜志, 2020, 40(6): 601-625.
11. Tanaka T, Hirano H, Ohara Y, et al. Oral Frailty Index-8 in the risk assessment of new-onset oral frailty and functional disability among community-dwelling older adults. Arch Gerontol Geriatr, 2021, 94: 104340. doi: 10.1016/j.archger.2021.104340.
12. 陳宗梅, 譚瑩, 梁遠俊, 等. 老年人口腔衰弱篩查量表的漢化及信效度檢驗. 護理研究, 2023, 37(21): 3808-3812.
13. Rolfson DB, Majumdar SR, Tsuyuki RT, et al. Validity and reliability of the Edmonton Frail Scale. Age Ageing, 2006, 35(5): 526-529.
14. 葛曉紅, 高麗紅. 埃德蒙頓衰弱量表的漢化及信效度檢驗. 中國實用護理雜志, 2021, 37(5): 352-358.
15. Kondrup J, Allison SP, Elia M, et al. ESPEN guidelines for nutrition screening 2002. Clin Nutr, 2003, 22(4): 415-421.
16. 林穎敏. 老年住院患者營養風險篩查及營養支持的應用. 山東大學, 2015.
17. Okunogbe A, Nugent R, Spencer G, et al. Economic impacts of overweight and obesity: current and future estimates for 161 countries. BMJ Glob Health, 2022, 7(9): e009773. doi: 10.1136/bmjgh-2022-009773.
18. 蔡明, 勵超, 熊振, 等. 預防性回腸造口還納技巧. 中華胃腸外科雜志, 2022, 25(11): 976-980.
19. 李易, 張紫嫣, 鄒炎鈴, 等. 住院癌癥患者口腔衰弱現狀及影響因素分析. 護理學雜志, 2024, 39(3): 49-52.
20. 韋靖怡, 趙秋艷, 黃維, 等. 養老機構老年人口腔衰弱發生情況及影響因素分析. 四川大學學報 (醫學版), 2024, 55(4): 947-957.
21. Castrejón-Pérez RC, Wanyonyi KL, García-Vázquez PE, et al. Frailty index and ten oral conditions in the Coyoacan cohort study: a cross-sectional analysis. Gerodontology, 2023, 40(3): 372-381.
22. 康靜, 蔣運蘭, 李滔, 等. 老年人口腔衰弱影響因素的Meta分析和系統評價. 數理醫藥學雜志, 2025, 38(2): 121-132.
23. Liu Q, Zhao M, Chen W, et al. Mainstream cigarette smoke induces autophagy and promotes apoptosis in oral mucosal epithelial cells. Arch Oral Biol, 2020, 111: 104646. doi: 10.1016/j.archoralbio.2019.104646.
24. 王敏, 楊文娟, 廖婷, 等. 社區老年人口腔衰弱風險預測模型的構建及驗證. 中華護理雜志, 2025, 60(3): 274-280.
25. 李寧寧, 田苗苗, 揣新慧, 等. 老年人口腔健康素養、營養狀況與口腔衰弱的關系. 牡丹江醫科大學學報, 2025, 46(1): 82-86.
26. Kim DH, Rockwood K. Frailty in older adults. N Engl J Med, 2024, 391(6): 538-548.
27. 趙薇, 戴夢萍, 郜司蓉, 等. 社區老年人多維度衰弱現狀及影響因素研究. 中國老年保健醫學, 2024, 22(2): 76-80.
28. 吳敏, 劉芮, 許采頡, 等. 老年慢性病共病患者口腔衰弱的潛在剖面分析及影響因素研究. 中華護理雜志, 2025, 60(15): 1804-1810.
29. Otálora-Otálora BA, López-Rivera JJ, Aristizábal-Guzmán C, et al. Host transcriptional regulatory genes and microbiome networks crosstalk through immune receptors establishing normal and tumor multiomics metafirm of the oral-gut-lung axis. Int J Mol Sci, 2023, 24(23): 16638. doi: 10.3390/ijms242316638.

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