Vandewoude M F J, Geerts C A M, d'Hooghe A H M, Paridaens K M J
Diensthoofd Universitair Centrum Geriatrie Antwerpen.
Tijdschr Gerontol Geriatr. 2006 Oct;37(5):203-9.
The proportional increase of the ageing population results in an ever growing percentage of elderly among hospitalised patients. Older patients have complex medical, social and psychological problems that could benefit from coordinated care or case management. Identification of high-risk older adults is mandatory to initiate a liaison geriatric management program. A simple screening tool is presented to identify older people at the time of admission who are at increased risk of adverse health outcomes. The instrument was validated during a period of 6 months when all (n = 618) older adults (> 70 year) hospitalised in non-geriatric departments of a general hospital were screened. This "Variable Indicative of Placement risk" (VIP) shows a good sensitivity (81%) and specificity (86%) and has a high Negative Predictive Value (97%). Furthermore, it shows a significant positive correlation with the length of stay (p < 0.001). The questionnaire turned out to be a very useful tool in the emergency department as well as in other wards because it probes premorbid frailty components with three simple questions. Due to its simplicity a nurse without geriatric training can complete it. Patients who are not at risk of an adverse outcome are easily recognised. A positive score indicates loss of functional independence and a risk of increased length of stay. Further geriatric assessment and intervention seem then appropriate.
老龄化人口的比例增加导致住院患者中老年人的比例不断上升。老年患者存在复杂的医疗、社会和心理问题，这些问题可通过协调护理或病例管理得到改善。识别高危老年人对于启动联络老年医学管理计划至关重要。本文介绍一种简单的筛查工具，用于识别入院时健康不良结局风险增加的老年人。该工具在6个月期间进行了验证，期间对一家综合医院非老年科住院的所有（n = 618）老年人（> 70岁）进行了筛查。这种“安置风险可变指标”（VIP）显示出良好的敏感性（81%）和特异性（86%），并且具有较高的阴性预测值（97%）。此外，它与住院时间呈显著正相关（p < 0.001）。该问卷在急诊科以及其他病房被证明是一个非常有用的工具，因为它通过三个简单问题探究病前虚弱成分。由于其简单性，未经老年医学培训的护士也可以完成。没有不良结局风险的患者很容易被识别出来。阳性评分表明功能独立性丧失以及住院时间延长的风险。那么进一步的老年医学评估和干预似乎是合适的。
