Incalzi R A, Gemma A, Capparella O, Terranova L, Porcedda P, Tresalti E, Carbonin P
Department of Geriatrics, Catholic University of the Sacred Heart, Rome.
J Gerontol. 1992 Mar;47(2):M35-9. doi: 10.1093/geronj/47.2.m35.
Three-hundred-eight geriatric patients (mean age = 76.7 yr, range = 70-94 yr) consecutively admitted to an acute care general hospital were followed up to identify the predictors of in-hospital mortality and long stay. Sociodemographic, medical, and functional data were collected within 24 hours from admission and their correlation with the outcomes assessed by logistic regression analysis. The following variables were shown to be independent predictors of death: use of more than 6 drugs (odds ratio = 3.04, confidence limits = 1.05-8.76); abnormal Mini-Mental State score (o.r. = 1.72, c.l. = 1.05-1.83); low ADL score (o.r. = 2.4, c.l. = 1.07-5.56). Extended stay was significantly and independently predicted by polypharmacy (o.r. = 1.94, c.l. = 1.18-3.2) and comorbidity (o.r. = 2.06, c.l. = 1.24-3.38). The mortality rates of patients with cognitive impairment and polypharmacy with or without functional impairment were 40% and 22%, respectively. The proposed method allows identification of high-risk geriatric inpatients by a simple medical and functional assessment on admission.
对一家综合急症医院连续收治的308名老年患者（平均年龄=76.7岁，范围=70-94岁）进行随访，以确定院内死亡率和长期住院的预测因素。在入院后24小时内收集社会人口学、医学和功能数据，并通过逻辑回归分析评估它们与结果的相关性。以下变量被证明是死亡的独立预测因素：使用6种以上药物（比值比=3.04，置信区间=1.05-8.76）；简易精神状态评分异常（比值比=1.72，置信区间=1.05-1.83）；日常生活活动能力评分低（比值比=2.4，置信区间=1.07-5.56）。多重用药（比值比=1.94，置信区间=1.18-3.2）和合并症（比值比=2.06，置信区间=1.24-3.38）是长期住院的显著且独立的预测因素。有认知障碍的患者以及有或无功能障碍的多重用药患者的死亡率分别为40%和22%。所提出的方法允许通过入院时简单的医学和功能评估来识别高危老年住院患者。
