急诊科观察单元中的老年评估与干预降低了再就诊率和住院率。

Geriatric assessment and intervention in an emergency department observation unit reduced re-attendance and hospitalisation rates.

作者信息

Foo Chik Loon, Siu Vivian Wing Yin, Tan Thai Lian, Ding Yew Yoong, Seow Eillyne

机构信息

Emergency Department, Tan Tock Seng Hospital, Singapore.

出版信息

Australas J Ageing. 2012 Mar;31(1):40-6. doi: 10.1111/j.1741-6612.2010.00499.x. Epub 2011 Aug 24.

DOI:10.1111/j.1741-6612.2010.00499.x

PMID:22417153

Abstract

AIM

To determine the efficacy of geriatric assessment and intervention in an emergency department observation unit (EDOU).

METHODS

This was a single-centre, before/after prospective study. The control group received the usual EDOU care. Intervention group received geriatric assessment and intervention before discharge. Patients were followed up at 3, 6, 9 and 12 months. End-points included falls and functional scores obtained via telephone, and unscheduled ED re-attendance and hospitalisation obtained through electronic records.

RESULTS

The study population included 172 control and 315 intervention group patients. A total of 71.7% of patients in the intervention group had hidden needs that required intervention. The intervention group had significantly less ED re-attendance (adjusted incidence rate ratio (IRR) 0.59, 95% confidence interval (CI) 0.48-0.71) and hospitalisation rates (adjusted IRR 0.64, 95% CI 0.51-0.79) at 12 months.

CONCLUSION

Older patients admitted to an EDOU are an at-risk group and benefit from geriatric assessment before discharge.

摘要

目的

确定老年评估与干预在急诊科观察单元（EDOU）中的疗效。

方法

这是一项单中心前瞻性前后对照研究。对照组接受EDOU常规护理。干预组在出院前接受老年评估与干预。在3、6、9和12个月时对患者进行随访。终点指标包括通过电话获得的跌倒情况和功能评分，以及通过电子记录获得的非计划重返急诊科就诊和住院情况。

结果

研究人群包括172名对照组患者和315名干预组患者。干预组中共有71.7%的患者存在需要干预的潜在需求。干预组在12个月时的重返急诊科就诊率（调整后的发病率比（IRR）为0.59，95%置信区间（CI）为0.48 - 0.71）和住院率（调整后的IRR为0.64，95%CI为0.51 - 0.79）显著更低。