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在一家亚急性老年医院住院的九旬和十旬患者的特征及预后

Characteristics and outcomes of ninth and tenth decade patients hospitalized in a sub-acute geriatric hospital.

作者信息

Yust-Katz Shlomit, Katz-Leurer Michal, Katz Lior, Lerman Yaffa, Slutzki Katia, Ohry Avi

机构信息

Departments of Neurology, Rabin Medical Center (Beilinson Campus), Petah Tiqva, Israel.

出版信息

Isr Med Assoc J. 2005 Oct;7(10):635-8.

Abstract

BACKGROUND

Population structures are changing across the western world, with particularly rapid growth in the number of very old people. Life expectancy has been increasing gradually over years, resulting in a larger subpopulation of people aged 90 and over.

OBJECTIVES

To describe the sociodemographic, medical and functional characteristics of people aged 80-90 and 90+ who were admitted to a sub-acute geriatric hospital and to compare the hospitalization outcomes between these subgroups.

METHODS

We compared the demographic and clinical data (extracted by means of chart review) of two groups of elderly who were admitted to the Reuth Medical Center during 2001-2002: those aged 90+ and those 80-89. Among survivors, the main outcome measures at discharge were mortality rate, functional ability, and place of residence.

RESULTS

The study included 108 patients who were admitted to different divisions of Reuth: 55 patients aged 90+ and 53 aged 80-90. The mortality rate was significantly elevated in the older age group (49.1% vs. 28.1% in the younger age group). On multivariate analysis, the most important prognostic factors for mortality were incontinence (odds ratio 3.45) and being dependent before admission (OR 4.76). Among survivors, an association was found between being incontinent and dependent before hospitalization, and being dependent on discharge.

CONCLUSIONS

The main prognostic factors for mortality and functional outcome in patients admitted to a non-acute geriatric hospital are incontinence and functional state prior to admission, and not age per se.

摘要

背景

西方世界的人口结构正在发生变化,高龄老人数量增长尤为迅速。多年来预期寿命一直在逐步提高,导致90岁及以上的老年人口增多。

目的

描述入住亚急性老年医院的80 - 90岁及90岁以上人群的社会人口学、医学和功能特征,并比较这些亚组之间的住院结局。

方法

我们比较了2001 - 2002年期间入住鲁思医疗中心的两组老年人的人口统计学和临床数据(通过病历审查提取):90岁及以上的老年人和80 - 89岁的老年人。在幸存者中,出院时的主要结局指标为死亡率、功能能力和居住地点。

结果

该研究纳入了108名入住鲁思不同科室的患者:55名90岁及以上患者和53名80 - 90岁患者。老年组的死亡率显著升高(49.1% vs. 年轻组的28.1%)。多因素分析显示,死亡的最重要预后因素是失禁(比值比3.45)和入院前依赖他人(比值比4.76)。在幸存者中,发现住院前失禁和依赖他人与出院时依赖他人之间存在关联。

结论

入住非急性老年医院患者死亡和功能结局的主要预后因素是失禁和入院前的功能状态,而非年龄本身。

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