Cleveland Clinic Health System, Cleveland, Ohio, USA.
Geriatr Gerontol Int. 2013 Apr;13(2):342-50. doi: 10.1111/j.1447-0594.2012.00905.x. Epub 2012 Jul 5.
To examine whether a team-based inpatient "geriatric" care model provided by non-geriatrics specialist physicians was associated with changes in the occurrence of delirium and transition to a nursing home.
We carried out an intervention (interdisciplinary; ITD group) control (usual care group) study comparing the outcomes of hospitalized older adults cared for by non-geriatrics specialist physicians. Compared with the usual care group, the ITD intervention group provided additional value: geriatric care and care coordination by leading daily ITD team meetings.
After adjusting for patient demographics and clinical characteristics, the probability of transition to a nursing home in the ITD intervention group was significantly lower (odds ratio 0.52; 95% confidence intervals, 0.16-0.94; P = 0.008) than that in the usual care group. However, there was no significant difference in the predicted probabilities of delirium between the ITD intervention and usual care groups.
As compared with the usual care group, a significantly lower probability of transition to a nursing home was observed in the ITD intervention group, but the probabilities of delirium between the ITD intervention and usual care groups did not differ significantly.
研究由非老年病学专家医师提供的基于团队的住院“老年病”护理模式是否与谵妄的发生和向疗养院转移的变化有关。
我们进行了一项干预（多学科；ITD 组）对照（常规护理组）研究，比较了由非老年病学专家医师护理的住院老年患者的结局。与常规护理组相比，ITD 干预组提供了额外的价值：由 ITD 每日团队会议主导的老年护理和护理协调。
在调整了患者人口统计学和临床特征后，ITD 干预组向疗养院转移的概率显著降低（优势比 0.52；95%置信区间，0.16-0.94；P=0.008），而常规护理组的差异无统计学意义。然而，在 ITD 干预组和常规护理组之间，谵妄的预测概率没有显著差异。
与常规护理组相比，ITD 干预组向疗养院转移的概率显著降低，但 ITD 干预组和常规护理组之间的谵妄概率没有显著差异。
