老年人综合评估和干预对出院患者预后的影响  

Effects of comprehensive geriatric assessment and health intervention on outcome in discharged patients

作　　者：林妍[1] 王雷懿[1] 王震[1] 王海峰[1] 周琦[1] 

机构地区：[1]同济大学附属同济医院干部保健科,上海200065

出　　处：《中华老年医学杂志》2014年第10期1089-1092,共4页Chinese Journal of Geriatrics

基　　金：基金项目：上海市干部保健基金（2011GB26）

摘　　要：目的 探讨运用老年人综合评估方法（CGA）和干预措施对出院患者预后的影响。方法 选取我院老年科2012年5-7月符合条件的出院患者72例,随机分为对照组和干预组,每组患者36例.两组患者均在出院时给予老年人CGA评估,随访3个月内对对照组患者仅进行追踪随访,不给予任何干预措施,而对干预组患者则在出院时、出院后1周、3周和3个月均给予健康干预。比较3个月后两组患者的综合患病状况、生活能力指标、再次入院情况和生存情况. 结果 3个月后干预组患者综合患病状况改良老年疾病累计评分量表（MCIRS-G）评分（29.06±4.51）分、生活能力ADL和IADL评分（75.69±16.57）分和（11.72±3.20）分,较对照组（33.09±4.34）分、（63.86±19.37）分和（9.77±2.52）分明显好转（t=3.84、2.77、2.85,均P=0.010）。干预组再次入院总次数3次,明显低于对照组17次（x2=8.79,P=0.020）;干预组再次住院天数（1.94±6.68）d,明显低于对照组（8.81±14.09）d（t=2.64,P=0.010）.对照组35例存活,1例死亡,干预组36例均存活,两组存活人数比较差异无统计学意义（x2=1.01,P=0.300）. 结论 对老年人进行综合评估和健康干预可以缓解出院患者的疾病症状、改善生活能力。Objective To investigate the effects of comprehensive geriatric assessment （CGA） and health intervention on outcome in discharged patients.Methods Discharged patients in geriatric ward from May to July 2012 were randomly assigned to control （n=36） and intervention （n=36） groups.Patients in the two groups were given comprehensive geriatric assessment （CGA） before discharging from hospital.Both groups were followed up for 3 months.Patients in intervention group received health intervention when leaving hospital,at 1 week,3 weeks and 3 months after discharge from hospital,while patients in control group were not given any intervention.The comprehensive illness condition （MCIRS-G）,ability of daily life （ADL and IADL）,rehospitalization and survival rate were compared between the two groups 3 months after the intervention.Results After 3 months,the scores of MCIRS-G,ADL and IADL were significantly better in intervention group than in control group[（29.06±4.51） vs.（33.09±4.34）,（75.69±16.57）vs.（63.86±19.37）,（11.72±3.20） vs.（9.77±2.52）,respectively,t=3.84,2.77,2.85,all P=0.01].The total times ofreadmission and readmission length were less in intervention group than in control group [3 vs.17,x2 =8.79,P=0.02; （1.94±6.68） days vs.（8.81±14.09） days,t=2.64,P=0.01].There was no difference in survival rate between the two groups [100% （36/36） vs.97.2% （35/36）,x2=1.01,P=0.30].Conclusions Comprehensive geriatric assessment and health intervention can alleviate symptoms and improve the ability of daily life.

关 键 词：老年人身心健康评价 干预性研究 

分 类 号：R592[医药卫生—老年医学]