McCormick W C, Inui T S, Deyo R A, Wood R W
University of Washington, Department of Medicine, Seattle 98195.
J Gen Intern Med. 1991 Jan-Feb;6(1):27-34. doi: 10.1007/BF02599386.
As the treatment for HIV infection has improved, AIDS has become a chronic disease, and the demand for long-term care has increased. The authors studied a cohort of hospitalized persons with AIDS to determine the proportion and characteristics of AIDS patients who could appropriately be cared for in long-term care facilities with skilled nursing.
Prospective cohort study.
Medical wards of five Seattle tertiary care hospitals.
120 consecutive hospitalized persons with AIDS and their primary care physicians, nurses, and social workers.
Appropriateness for long-term care was determined by the patients' physicians, nurses, and social workers. Persons with AIDS who were appropriate for long-term care constituted 32% of the cohort (38 of 120), accounting for 35% of hospital days (11 of these 38 were discharged to long-term care facilities). Four admission characteristics were independently related to appropriateness: impaired activities of daily living, diagnosis of central nervous system illness or poor cognition, living alone, and weight loss. A discriminant function correctly classified over 80% of patients for appropriateness and was developed into a predictive index for planning patient care (sensitivity = 0.74, specificity = 0.85).
The authors conclude that one-third of hospitalized persons with AIDS may be appropriate for care in long-term care settings, accounting for one-third of the days AIDS patients currently spend in hospitals. These patients can be identified early in hospital stays using a simple predictive index at the bedside.
随着人类免疫缺陷病毒（HIV）感染治疗方法的改进，艾滋病已成为一种慢性病，对长期护理的需求也有所增加。作者对一组住院的艾滋病患者进行了研究，以确定适合在配备专业护理的长期护理机构中接受护理的艾滋病患者的比例和特征。
前瞻性队列研究。
西雅图五家三级护理医院的内科病房。
120名连续住院的艾滋病患者及其初级保健医生、护士和社会工作者。
长期护理的适宜性由患者的医生、护士和社会工作者确定。适合长期护理的艾滋病患者占该队列的32%（120例中的38例），占住院天数的35%（这38例中有11例出院后前往长期护理机构）。有四个入院特征与适宜性独立相关：日常生活活动能力受损、中枢神经系统疾病诊断或认知能力差、独居和体重减轻。一个判别函数对患者适宜性的正确分类率超过80%，并被开发成一个用于规划患者护理的预测指数（敏感性 = 0.74，特异性 = 0.85）。
作者得出结论，三分之一的住院艾滋病患者可能适合在长期护理机构接受护理，占艾滋病患者目前住院天数的三分之一。这些患者可以在住院早期通过床边简单的预测指数进行识别。
