Hogan D B, Fox R A
Camp Hill Hospital, Halifax, Nova Scotia, Canada.
Age Ageing. 1990 Mar;19(2):107-13. doi: 10.1093/ageing/19.2.107.
Attempts to prove the usefulness of geriatric consultation teams (GCT) in acute-care settings have been inconclusive. We have completed a prospective, controlled trial of a GCT in an acute-care setting, aiming our interventions at a specific subgroup of elderly patients. One hundred and thirty-two out of 352 (37.5%) patients met the inclusion criteria with 66 each being assigned to the intervention and the control groups. There were no significant differences in baseline characteristics between the two groups. Patients in the intervention group received follow-up after discharge from hospital by the geriatric service. We found that the intervention was associated with improved 6-month survival (p less than 0.01), improved Barthel Index at 1 year (p less than 0.01), and a trend towards decreased reliance on institutional care (hospital or nursing home) during the year of follow-up. The benefits occurred principally in patients who were discharged to a nursing home. Our findings support the utility of GCT and highlight the importance of focusing the intervention and providing follow-up after discharge from hospital.
在急性护理环境中证明老年病咨询团队(GCT)有用性的尝试尚无定论。我们在急性护理环境中完成了一项关于GCT的前瞻性对照试验,将干预措施针对老年患者的一个特定亚组。352名患者中有132名(37.5%)符合纳入标准,每组66名被分配到干预组和对照组。两组的基线特征无显著差异。干预组患者出院后由老年病服务机构进行随访。我们发现,干预与6个月生存率提高(p<0.01)、1年时Barthel指数改善(p<0.01)以及随访期间对机构护理(医院或疗养院)的依赖有下降趋势有关。这些益处主要发生在出院后入住疗养院的患者中。我们的研究结果支持GCT的实用性,并强调了集中干预和出院后提供随访的重要性。