老年急症患者衰弱状态与住院时长的相关性分析
Correlation between frailty and length of hospital stay in elderly acute care patients
朱思颖 1孙乙灵 2林琦琦 1孟繁森 1刘睿 3惠海鹏 4王刚石1
作者信息
- 1. 100853 北京,解放军总医院第二医学中心消化内科国家老年疾病临床医学研究中心
- 2. 北京市海淀区第三十八离职干部休养所
- 3. 100853 北京,解放军总医院第二医学中心老年医学科
- 4. 100853 北京,解放军总医院第二医学中心保健七科
- 折叠
摘要
目的 探索急症住院老年患者衰弱状态的动态变化及其与住院时长的关系.方法 选取 2019 年～2022 年因急症至解放军总医院第二医学中心就诊并入院治疗的老年患者 112 例.采用国际居民评估工具急性病照护-老年综合评估系统(InterRAI AC-CGA)评估量表分别于患者入院后 3 d内(初评)、7 d(复评)、28 d(住院时间<28 d者在出院前 1 天评估)(终评)进行采集患者功能状态数据,提取衰弱指数(FI)相关信息,建立FI-AC-CGA模型评估患者衰弱状态.采用logistic回归分析患者衰弱状态与住院时长的关系.结果 入组的 112 例患者中,男性 103 例(92.0%).初评无衰弱 29 例(25.9%),轻度衰弱 27 例(24.1%),中度衰弱 32 例(28.6%),重度衰弱 24 例(21.4%).与初评相比,复评和终评时的无衰弱人数增加,中度衰弱和重度衰弱人数减少.多因素回归分析显示,衰弱状态是住院时间延长的危险因素(OR= 5.987,95%CI= 1.101～32.553,P=0.038).衰弱恶化组相较于衰弱改善组,住院时间[35(29,90)d vs.29(20,41)d]显著延长,差异有统计学意义(Z=-3.284,P=0.001).结论 FI-AC-CGA模型可以动态评估老年急症患者的衰弱状态,其动态变化与住院时长相关,衰弱状态恶化的患者住院时间更长.
Abstract
Objective To explore the relationship between the changes of frailty and the length of hospital stay in elderly emergency patients.Methods We selected elderly patients admitted to the Second Medical Center of Chinese PLA General Hospital from 2019 to 2022 due to acute diseases.Then we used the InterRAI Acute Care for Comprehensive Geriatric Assessment(AC-CGA)to collect the patient's data,and assessed within 3 days after admission(initial assessment),7 days(reassessment)and 28 days(the length of hospital stay<28 days were assessed on the day before discharge)(final assessment).The frailty index(FI)was extracted from 53 items of the InterRAI AC-CGA,and the FI-AC-CGA model was established to evaluate the frailty status of patients.Logistic regression was used to analyze the relationship between frailty and length of hospital stay.Results Of the 112 patients enrolled,103 were males,with an age range of 60-101 years.At the initial evaluation,29 patients were robust,27 patients were mild frailty,32 patients were moderate frailty,and 24 patients were severe frailty.Compared with the initial evaluation,the number of robust people increased during the re-evaluation and final evaluation,and the number of people with moderate frailty and severe frailty decreased.Multivariate regression analysis showed that frailty was a risk factor for prolonged hospital stay(OR = 5.987,95%CI = 1.101～32.553,P=0.038).The length of hospital stay in the frailty deterioration group was longer than that in the frailty improvement group,Z=-3.284,P=0.001).Conclusion The frailty status and its dynamic changes in elderly emergency patients assessed based on the FI-AC-CGA model are correlated with the length of hospital stay,and patients with worsening frailty have longer hospital stay.
关键词
老年急症患者/国际居民评估工具急性病照护-老年综合评估系统/衰弱/住院时间Key words
Elderly emergency inpatients/InterRAI AC-CGA/Frailty/The length of hospital stay引用本文复制引用
基金项目
军委后勤保障部保健课题(18BJZ22)
国家社会科学基金(21&ZD294)
出版年
2024
NETL
NSTL
万方数据