Department of Family Medicine, College of Medicine and Hospital, National Taiwan University, Bei-Hu Branch, No. 37 Kangding Rd., Taipei City, Taiwan.
Arch Gerontol Geriatr. 2010 Feb;50 Suppl 1:S30-3. doi: 10.1016/S0167-4943(10)70009-1.
The purpose of this study was to evaluate the outcomes of elderly inpatients with geriatric syndromes. A prospective study involving patients aged 65 years and older in 12 community hospitals was performed. Baseline data, which included demographic characteristics, mini mental status exam, geriatric depression scale (GDS), mini nutritional assessment (MNA), activities of daily living (ADL), and instrumental activities of daily living (IADL), were collected in geriatric assessments. The primary outcome was functional deterioration; additional outcomes included mortality, re-hospitalization, and emergency department visits, as identified by telephone interview and chart review. A total of 1,008 patients were recruited: 31.2% of the participants were ADL intact, 21.3% were IADL-intact, 11.5% had depression, 29.3% had nutritional problems, and 60.3% had impaired cognition at baseline. During follow-up, 172 patients (19.3%) died, 43.8% reported ADL deterioration, and 45.9% reported IADL deterioration. On multivariate analysis, older age, low mini mental state examination (MMSE) score, and low MNA score were predictors of functional deterioration. Under the interdisciplinary team care of the Community Hospital Reform Plan (CHRP), most of the elderly patients maintained or increased their functional capacity; the one-year mortality rate was higher than that of the general population but lower than that of other studies targeting the frail elderly.
本研究旨在评估老年综合医院老年综合征患者的结局。采用前瞻性研究方法，纳入 12 家社区医院年龄≥65 岁的患者。在老年综合评估中收集基线数据，包括人口统计学特征、简易精神状态检查、老年抑郁量表、微型营养评估、日常生活活动能力和工具性日常生活活动能力。主要结局为功能恶化；次要结局包括通过电话访谈和病历回顾确定的死亡率、再住院率和急诊就诊率。共纳入 1008 例患者：31.2%的患者日常生活活动能力完好，21.3%的患者工具性日常生活活动能力完好，11.5%的患者有抑郁，29.3%的患者有营养问题，60.3%的患者在基线时有认知障碍。随访期间，172 例（19.3%）患者死亡，43.8%的患者报告日常生活活动能力恶化，45.9%的患者报告工具性日常生活活动能力恶化。多变量分析显示，年龄较大、简易精神状态检查评分较低和微型营养评估评分较低是功能恶化的预测因素。在社区医院改革计划（CHRP）的跨学科团队护理下，大多数老年患者维持或增加了他们的功能能力；一年死亡率高于一般人群，但低于其他针对体弱老年人的研究。
