Department of Medicine, Division of Geriatric Medicine, Sir Mortimer B. Davis - Jewish General Hospital and Lady Davis Institute for Medical Research, McGill University, Montreal, Quebec, Canada; Dr. Joseph Kaufmann Chair in Geriatric Medicine, Faculty of Medicine, McGill University, Montreal, Quebec, Canada; Centre of Excellence on Longevity of McGill integrated University Health Network, Quebec, Canada.
Department of Medicine, Division of Geriatric Medicine, St. Mary's Hospital Center, McGill University, Montreal, Quebec, Canada.
Maturitas. 2018 Sep;115:110-114. doi: 10.1016/j.maturitas.2018.06.014. Epub 2018 Jul 2.
Morbidities and related disabilities often lead to older inpatients having a long hospital stay. The aim of this study was to examine whether the 6-item brief geriatric assessment (BGA), developed and validated in France to determine a priori levels of risk of a long hospital stay (i.e.; low, moderate, high), could be successfully used with patients admitted to a geriatric assessment unit (GAU) in Quebec.
Observational retrospective cohort design.
A GAU of a McGill University affiliated hospital (Montreal, Quebec, Canada).
499 inpatients (84.7 ± 7.2 years; 73.3% female) recruited upon their admission.
The BGA comprises 6 items: age > 85 years, male gender, ≥ 5 drugs per day, use of home-help support, history of falls and temporal disorientation. It was administered at baseline and a priori levels of risk of a long hospital stay (i.e., low, moderate, high) were determined. Length of hospital stay (LHS, in days) was calculated using the hospital registry. The association between a priori levels of risk from the BGA and LSH was examined using regression models and Kaplan-Meier curves.
The LHS increased with the 6-item BGA a priori level of risk (P = 0.010). High-risk (Hazard ratio (HR) = 1.68 with P < 0.001) and moderate-risk (HR = 1.24 with P = 0.039) of a long hospital stay successfully predicted a long stay. Kaplan-Meier distributions of time to discharge showed that inpatients classified as having high and moderate risk levels for a long hospital stay were discharged later than those with a low risk level (P < 0.001 and P = 0.013).
The 6-item BGA a priori levels of risk for a long hospital stay successfully predicted a long stay among patients admitted to a GAU in Quebec.
各种并发症和相关残疾往往导致老年住院患者住院时间延长。本研究旨在检验在法国开发并验证的用于确定住院时间长短（即低危、中危、高危）的 6 项简明老年评估（BGA）是否可以成功用于魁北克老年评估病房（GAU）收治的患者。
观察性回顾性队列设计。
麦吉尔大学附属医院（加拿大蒙特利尔魁北克）的 GAU。
499 名入院患者（84.7±7.2 岁；73.3%为女性）在入院时入选。
BGA 包含 6 项内容：年龄>85 岁、男性、每日服用>5 种药物、使用家庭护理支持、有跌倒史和时间定向障碍。在基线时进行评估，并确定住院时间长短的预先设定风险（即低危、中危、高危）。使用医院登记系统计算住院时间（LHS，天数）。使用回归模型和 Kaplan-Meier 曲线检验 BGA 预先设定风险水平与 LHS 之间的关联。
LHS 随 BGA 预先设定的风险水平增加而增加（P=0.010）。高风险（HR=1.68，P<0.001）和中危（HR=1.24，P=0.039）的住院时间长短可准确预测住院时间延长。出院时间的 Kaplan-Meier 分布表明，被归类为具有高和中危水平的住院时间延长的住院患者的出院时间晚于低危水平的患者（P<0.001 和 P=0.013）。
BGA 预先设定的住院时间长短的风险水平可以成功预测魁北克 GAU 收治的患者的住院时间延长。
