老年综合征对老年患者非计划再入院的影响  

Effect of geriatric syndrome on unplanned readmission in elderly patients

作　　者：沈静[1] 管丽娟[1] 郑晓梅[1] 周莉华[1] 王凌霄 张焱[1] 李婷[1] 孙东[1] 陈善萍 彭洋 汪必会 赖荣美 罗庆 SHEN Jing;GUAN Li-Juan;ZHENG Xiao-Mei;ZHOU Li-Hua;WANG Ling-Xiao;ZHANG Yan;LI Ting;SUN Dong;CHEN Shan-Ping;PENG Yang;WANG Bi-Hui;LAI Rong-Mei;LUO Qing(Department of Geriatrics of Chengdu Municipal Fifth People′s Hospital,Chengdu China-Montpellier France Institute of Geriatric Diseases,Chengdu 611130,China)

机构地区：[1]成都市第五人民医院老年病科中国成都-法国蒙彼利埃老年疾病研究所

出　　处：《中华老年多器官疾病杂志》2020年第2期98-102,共5页Chinese Journal of Multiple Organ Diseases in the Elderly

基　　金：四川省卫生与计划生育委员会科研课题(150021)~~

摘　　要：目的了解住院老年共病患者非计划再入院的发生情况,探讨老年综合征对非计划再入院的影响。方法选取2015年1月至2017年12月于成都市第五人民医院老年病科住院的老年共病患者443例。通过老年综合评估筛查老年综合征,记录出院后2年内非计划再入院情况,并分析老年综合征对非计划再入院的影响。采用SPSS 24.0软件进行统计分析,多因素logistic回归分析筛选出独立的危险因素。结果在2年随访期内,199例(44.92%)患者存在非计划再入院。位于前5位的老年综合征分别为日常生活活动能力(ADL)依赖(n=269,60.72%)、营养不良风险(n=256,57.79%)、跌倒高风险(n=246,55.53%)、多重用药(n=237,53.50%)和衰弱(n=231,52.14%)。经多因素logistic回归对患者非计划再入院进行分析发现,营养不良(OR=1.522,95%CI 1.081~2.145;P=0.016)、跌倒高风险(OR=1.855,95%CI 1.219~2.825;P=0.004)、ADL受损(OR=1.649,95%CI 1.074~2.533;P=0.022)、多重用药(OR=1.597,95%CI 1.068~2.388;P=0.023)是影响患者2年内再入院的独立危险因素。结论老年共病患者非计划再入院率高,不同的老年综合征对再入院的时间及次数产生影响。Objective To investigate the occurrence of unplanned readmission in the elderly patients with comorbidities and to explore the effect of geriatric syndrome on unplanned readmission.Methods From January 2015 to December 2017,a total of 443 elderly cases with comorbidities were selected,who were hospitalized in Department of Geriatrics of the Fifth People′s Hospital of Chengdu.Geriatric syndrome was screened by comprehensive geriatric assessment,the patients were followed up for two years after discharge,and data were collected of the unplanned readmission within the period.Statistical analysis was performed using SPSS statistics 24.0,and independent risk factors were screened out by multivariate logistic regression analysis.Results Within the two-year follow-up,199(44.92%)patients were readmitted without plan.The top 5 in the geriatric syndrome were the dependence for activity of daily living(ADL)(n=269,60.72%),risk of malnutrition(n=256,57.79%),high-risk of fall(n=246,55.53%),multiple medications(n=237,53.50%),and weakness(n=231,52.14%).Multivariate logistic regression found that malnutrition(OR=1.522,95%CI 1.081-2.145;P=0.016),high-risk of fall(OR=1.855,95%CI 1.219-2.825;P=0.004),ADL impairment(OR=1.649,95%CI 1.074-2.533;P=0.022),polypharmacy(OR=1.597,95%CI 1.068-2.388;P=0.023)were independent risk factors for readmission within 2 years.Conclusion The readmission rate in elderly patients with comorbidities is high,and the geriatric syndrome has effect on the time and frequency of readmission.

关 键 词：老年人 共病 老年综合征 非计划再入院 

分 类 号：R592[医药卫生—老年医学]