Zulfiqar Abrar-Ahmad
Département de médecine interne-gériatrie-thérapeutique, CHU Rouen, Site Saint-Julien, Rouen, France.
Geriatr Psychol Neuropsychiatr Vieil. 2018 Sep 1;16(3):269-277. doi: 10.1684/pnv.2018.0740.
At present, it is recognized that screening for frailty in the elderly is a major public health issue. Numerous scales have emerged for the purpose of detecting/measuring frailty.
A prospective, observational study was performed in subjects aged over 75 years, coming from the first neuro-geriatric consultation, from July 3, 2017 to August 18, 2017, included in the CHU Rouen, and benefiting from frailty screening through the use of the grid SEGAm (part A); this correlated with the subjective opinion of the nurse.
58 patients were included, with an average age of 82.1±3.87 (extreme age: 75-95) and a slight female predominance (37 subjects, 63.8%). The mean Charlson score was 2.31±1.75. Home helpers were present for 34 patients. The elderly were in a couple for 35 patients. The mean weight of the series is 74.5±14.67. The mean BMI of the series is 26.85±4.79. The mean MMSE score is 22.8±3.28. Non-frail elderly subjects, according to the SEGAm scale, represent 45 patients, while the frail elderly represent 13 patients (22.4%). The average SEGAm score is 6.3±3.59. SEGAm achievement time is about 6.2 min. According to the feeling of the nursing team, 36 elderly patients (62%) were not frail, 15 elderly patients (26%) were frail, while 7 elderly patients were very frail (12%). Cohen's kappa was estimated at 0.56 (IC95: 0.33-0.79). Thus the agreement, according to Cohen's kappa, is estimated as average.
The SEGAm score appears to be a suitable outpatient score. It is easy to use, allows an overall assessment of the patient and is not time consuming. The objective of this work is to be able to develop at best frailty consultations or even a day hospital, the real objective of the main hospitals.
目前,人们认识到老年人衰弱筛查是一个重大的公共卫生问题。为了检测/测量衰弱,已经出现了许多量表。
对2017年7月3日至2017年8月18日在鲁昂大学医院接受首次神经老年病咨询的75岁以上患者进行了一项前瞻性观察研究,这些患者通过使用SEGAm量表(A部分)进行衰弱筛查;这与护士的主观意见相关。
纳入58例患者,平均年龄82.1±3.87岁(年龄范围:75 - 95岁),女性略占优势(37例,63.8%)。查尔森平均评分为2.31±1.75。34例患者有家庭护理人员。35例患者已婚。该系列患者的平均体重为74.5±14.67。该系列患者的平均BMI为26.85±4.79。平均MMSE评分为22.8±3.28。根据SEGAm量表,非衰弱老年患者有45例,而衰弱老年患者有13例(22.4%)。SEGAm平均评分为6.3±3.59。完成SEGAm量表的时间约为6.2分钟。根据护理团队的感觉,36例老年患者(62%)不衰弱,15例老年患者(26%)衰弱,而7例老年患者非常衰弱(12%)。科恩kappa系数估计为0.56(95%置信区间:0.33 - 0.79)。因此,根据科恩kappa系数,一致性估计为中等。
SEGAm评分似乎是一个合适的门诊评分量表。它易于使用,能够对患者进行全面评估且不耗时。这项工作的目标是能够最好地开展衰弱咨询甚至日间医院服务,这是主要医院的真正目标。