Department of Internal Medicine, Division of Geriatric and Palliative Medicine, University of Texas, and Memorial Hermann-Texas Medical Center, Houston, Texas, USA.
Popul Health Manag. 2010 Aug;13(4):219-25. doi: 10.1089/pop.2009.0058.
Traditionally, acute medical care has been insufficient to meet the complex care needs of frail older adults. The purpose of this study was to evaluate the effectiveness of Acute Care for the Elderly (ACE) units at improving hospitalization outcomes for adults older than 65 years of age. A review of the literature was performed, focusing on randomized controlled trials, clinical trials, reviews, and meta-analyses from 1990 to 2008. This review revealed ACE to be associated with positive global outcomes (eg, cost, length of stay, readmission rates, utilization, rehabilitation, cognition, function, patient/staff satisfaction). Furthermore, some studies may point to a decreased incidence of delirium and polypharmacy. Though larger studies with consistent operational definitions and replicative studies are needed, the literature presents compelling evidence that warrants further investigation of ACE as a valuable alternative paradigm of acute geriatric care.
传统上，急性医疗护理不足以满足体弱老年人的复杂护理需求。本研究旨在评估老年急性护理 (ACE) 病房在改善 65 岁以上成年人住院治疗结果方面的有效性。对文献进行了回顾，重点是 1990 年至 2008 年的随机对照试验、临床试验、综述和荟萃分析。该综述表明 ACE 与积极的总体结果（如成本、住院时间、再入院率、利用率、康复、认知、功能、患者/员工满意度）相关。此外，一些研究可能表明谵妄和多药治疗的发生率降低。尽管需要更大规模的研究，这些研究具有一致的操作定义和可复制性，但文献提供了令人信服的证据，证明有必要进一步研究 ACE 作为急性老年护理的有价值的替代模式。
