Abstract: Background　The number of elderly patients with coronary heart disease （CHD） is increasing year by year，and frailty is closely related to the prognosis of CHD．Early identification of frailty can prolong the survival time of patients and improve their quality of life．There are many methods to assess frailty，and frailty phenotype is commonly used at present．However，it requires evaluating physical fitness，which is time-consuming and inefficient．On the other hand，the FRAIL Scale is entirely based on patients' self-statement，which is simple and feasible．Objective　To explore the performance of the FRAIL Scale in screening frailty in elderly patients with CHD，with the determination of its optimal cut-off value.Methods　Participants were elderly patients with CHD who enrolled from Department of Cardiology，Affiliated Hospital of Yangzhou University from May to December in 2017.A self-developed Demographic Questionnaire was adopted to collect the demographic characteristics.Frailty was assessed by using both Fried frailty phenotype criteria and FRAIL Scale.ROC curve analysis was conducted to determine the optimal cut-off value of FRAIL Scale for screening frailty，and its clinical value was analyzed.308 of the 320 participants returned responsive questionnaires，obtaining a response rate of 96.2%.Results　For identifying frailty，the area under the ROC curve （AUC） of the FRAIL Scale for screening elderly patients with CHD was 0.858〔95%CI（0.811，0.906），P<0.01〕.When the optimal cut-off value was determined as 2 points，the Youden's index，sensitivity，specificity，positive predictive value and negative predictive value were 0.584，85.9%，72.5%，45.1% and 95.2%，respectively.Kappa statistic result （Kappa coefficient=0.438） showed a moderate level of agreement between the performance of FRAIL Scale and that of frailty phenotype （P<0.01）．Furthermore，a moderate correlation was found between the FRAIL score and the frailty phenotype score by Pearson analysis （r=0.668，P<0.01）．Conclusion　The FRAIL Scale was proved to be a good tool for the identification of frailty in elderly patients with CHD when using an optimal cut-off value of 2 points.Moreover，the assessment using it is simple and time-saving，so it is worthy of wide clinical application.

Key words: Coronary disease, FRAIL Scale, Diagnosis, Aged

摘要： 背景　目前老年冠心病患者逐年增多，且衰弱与冠心病的预后密切相关，及早识别衰弱，可延长患者寿命，提高生活质量。对于衰弱有多种评估方法，目前衰弱表型较为常用，但需要进行体能评估，耗时耗力，FRAIL量表则完全基于患者自我陈述，简单易行。目的　探讨FRAIL量表对老年冠心病伴衰弱患者的筛查价值，并计算最佳临界值。方法　选取2017年5—12月在扬州大学附属医院心内科住院的老年冠心病患者进行调查。采用自行设计的问卷调查一般资料，采用衰弱表型、FRAIL量表进行衰弱评估。采用受试者工作特征（ROC）曲线计算FRAIL量表筛查老年冠心病患者衰弱状态的最佳临界值，分析其临床价值。共发放问卷320份，回收有效问卷308份，有效回收率为96.2%。结果　FRAIL量表筛查老年冠心病的ROC曲线下面积（AUC）为0.858〔95%CI（0.811，0.906），P<0.01〕，最佳临界值为2分时，约登指数为0.584，灵敏度为85.9%，特异度为72.5%，阳性预测值为45.1%，阴性预测值为95.2%。FRAIL量表与衰弱表型一致性检验结果显示Kappa值为0.438，P<0.01，提示两者存在中度一致性；FRAIL量表和衰弱表型相关性分析结果显示，FRAIL量表与衰弱表型呈中度相关（r=0.668，P<0.01）。结论　FRAIL量表筛查老年冠心病伴衰弱患者的最佳临界值为2分，筛查价值较好，简单易操作且省时，可在临床进行推广。

关键词: 冠心病, FRAIL量表, 诊断, 老年人