Instituto de Geriatría, Secretaría de Salud, Periférico Sur 2767, Colonia San Jerónimo Lídice, Delegación Magdalena Contreras, CP 10200, Mexico City, Mexico.
Arch Gerontol Geriatr. 2012 May-Jun;54(3):e370-5. doi: 10.1016/j.archger.2011.05.028. Epub 2011 Jul 22.
There is evidence that geriatric services may be more effective in handling problems of the elderly in acute care. We therefore studied a cohort of matched triplets (age, gender and admission diagnosis), to assess the effect of a geriatric service on elderly problems (falls, pressure ulcers, delirium and functional decline). This is a follow up study; comparing a geriatric unit with an internal medicine unit at two hospitals of the Mexican Institute of Social Security (IMSS) in Mexico City. Socio-demographic characteristics, functionality, emotional state, cognitive status, delirium, co-morbidities, diagnosis, number of medications, presence of pressure ulcers and falls, were assessed. We developed a composite variable as a global end-point, including: delirium, falls, mortality, pressure sores and functional decline. 70 patients were included in the geriatric services and 140 in the internal medicine unit. Mean age =72.5±7 years (±S.D.), and 52.9% were women. At baseline, only illiteracy, quality of life and the number of medications were statistically different between each group. Fully adjusted multiple logistic conditional regression model found an odds ratio of 0.27 (95% CI 0.1-0.7) for the presence of the composite variable, favoring the geriatric unit. Geriatric units in acute care may be beneficial in different frequent end points in elderly.
有证据表明,老年科服务在处理急性护理中老年人的问题方面可能更有效。因此,我们研究了一组匹配的三胞胎(年龄、性别和入院诊断),以评估老年科服务对老年人问题(跌倒、压疮、谵妄和功能下降)的影响。这是一项随访研究;比较了墨西哥社会保障研究所(IMSS)在墨西哥城的两家医院的老年科和内科。评估了社会人口统计学特征、功能、情绪状态、认知状态、谵妄、合并症、诊断、药物数量、压疮和跌倒的发生情况。我们开发了一个综合变量作为整体终点,包括:谵妄、跌倒、死亡率、压疮和功能下降。70 名患者被纳入老年科服务,140 名患者被纳入内科。平均年龄为 72.5±7 岁(±标准差),52.9%为女性。在基线时,只有文盲、生活质量和药物数量在每组之间存在统计学差异。完全调整后的多元逻辑条件回归模型发现,综合变量的存在的优势比为 0.27(95%置信区间 0.1-0.7),有利于老年科。急性护理中的老年科可能对老年人不同的常见终点有益。