Gan Neesha, Large Julienne, Basic David, Jennings Natalie
Aged Care Unit, Liverpool Hospital, Liverpool, NSW, Australia.
Aust J Physiother. 2006;52(2):141-4. doi: 10.1016/s0004-9514(06)70050-2.
This study aimed to determine whether the admission Timed Up and Go Test (TUG) predicted the length of stay of patients in an acute geriatric ward. Consecutive patients were quasi-randomly allocated to either a model development sample or a model validation sample. Multivariate Cox proportional hazards regression was used to model length of stay. Variables considered for inclusion in the development model were risk factors for length of stay reported in the literature and univariate predictors from our dataset (p < 0.05). Variables selected for use in the development sample were then tested in the validation sample. Of 2463 patients of mean age 82.1 years, 932 (37.8%) were able to complete the TUG. Despite a significant, though weak, relationship between the length of stay and the TUG time (Spearman coefficient 0.18, p < 0.001), no time clearly identified patients with longer length of stay. Patients unable to complete the TUG had a median length of stay of 11 days (IQR 7 to 18), 40% longer than those able to complete the TUG (median 8 days, IQR 8 to 12, p < 0.001). Other significant (p < 0.05) predictors of length of stay in both samples were number of active medical diagnoses, referral from the emergency department, in-patient fall, and diagnosis of ulcer or infection. The admission TUG time should not be used to screen for patients likely to have longer lengths of stay. The value of the TUG lies in determining the patient's ability to complete it, rather than the time taken.
本研究旨在确定入院时的计时起立行走测试（TUG）能否预测老年急性病病房患者的住院时间。连续的患者被准随机分配到模型开发样本或模型验证样本中。采用多变量Cox比例风险回归模型来模拟住院时间。纳入开发模型的变量包括文献中报道的住院时间风险因素以及我们数据集中的单变量预测因素（p<0.05）。然后在验证样本中测试在开发样本中选择使用的变量。在2463名平均年龄为82.1岁的患者中，932名（37.8%）能够完成TUG测试。尽管住院时间与TUG测试时间之间存在显著但微弱的关系（Spearman系数为0.18，p<0.001），但没有一个时间能明确识别出住院时间较长的患者。无法完成TUG测试的患者住院时间中位数为11天（四分位间距为7至18天），比能够完成TUG测试的患者长40%（中位数为8天，四分位间距为8至12天，p<0.001）。两个样本中住院时间的其他显著（p<0.05）预测因素包括活跃的医学诊断数量、急诊科转诊、住院期间跌倒以及溃疡或感染的诊断。不应使用入院时的TUG测试时间来筛查可能住院时间较长的患者。TUG测试的价值在于确定患者完成该测试的能力，而非所花费的时间。
