Division of Allergy, Immunology and Rheumatology, Taichung Veterans General Hospital, No. 160 Section 3 Taichung-Kang Road, Taichung, Taiwan.
Arch Gerontol Geriatr. 2010 Feb;50 Suppl 1:S1-5. doi: 10.1016/S0167-4943(10)00041-5.
Elderly patients who are hospitalized with acute illnesses frequently have adverse outcomes. To maintain functional independence, the geriatric evaluation and management unit (GEMU) was established to provide the opportunity for functional recovery (FR). This study's aim was to investigate potential prognostic factors for functional improvement in a GEMU of Taichung Veterans General Hospital, Taiwan. A total of 117 elderly patients (age, 80.0+/-6.3 years, 84.6% males) were enrolled. A comprehensive geriatric assessment and functional status evaluation, including the functional reach test (FRT) and the timed up-and-go (TUG) test, were performed. FR was defined by a greater than 10% improvement in the Barthel Index (BI) before GEMU discharge. Lower BI (44.7+/-25.2 vs. 68.7+/-34.5, p < 0.001), lower instrumental activities of daily living (IADL) scores (1.8+/-1.5 vs. 3.5+/-2.6, p < 0.001), impaired FRT (83.3% vs. 63.5%, p = 0.028), and impaired TUG test (94.4% vs. 74.6%, p = 0.008) were predictive factors for functional improvement. On multivariate logistic regression, an impaired TUG test (Odds ratio = OR = 6.18, 95% confidence interval = 95% C.I. = 1.69-22.6, p = 0.006) was an independent variable associated with FR. The results indicate that elderly hospitalized patients, even with poor physical function, could benefit from geriatric integrated care delivered by a GEMU.
患有急性疾病而住院的老年患者常出现不良预后。为了维持功能独立性,设立了老年评估和管理单元(GEMU)以提供功能恢复(FR)的机会。本研究旨在探讨台湾台中荣民总医院 GEMU 中影响功能改善的潜在预后因素。共纳入 117 名老年患者(年龄 80.0+/-6.3 岁,84.6%为男性)。进行全面的老年评估和功能状态评估,包括功能伸手测试(FRT)和计时起立行走测试(TUG)。GEMU 出院前 Barthel 指数(BI)增加超过 10%定义为 FR。较低的 BI(44.7+/-25.2 比 68.7+/-34.5,p < 0.001)、较低的工具性日常生活活动(IADL)评分(1.8+/-1.5 比 3.5+/-2.6,p < 0.001)、受损的 FRT(83.3%比 63.5%,p = 0.028)和受损的 TUG 测试(94.4%比 74.6%,p = 0.008)是 FR 的预测因素。多变量逻辑回归分析显示,受损的 TUG 测试(比值比[OR] = 6.18,95%置信区间[95% CI] = 1.69-22.6,p = 0.006)是与 FR 相关的独立变量。结果表明,即使身体功能较差,住院的老年患者也可从 GEMU 提供的老年综合护理中获益。