Hospital Israelita Albert Einstein, Alameda dos Jurupis 777, apartment 242, Sao Paulo, CEP 04088001, Brazil.
Universidade Federal de São Paulo, Sao Paulo, Brazil.
BMC Geriatr. 2019 Mar 21;19(1):89. doi: 10.1186/s12877-019-1104-4.
The study objectives were to identify the main predictive factors for long hospital stays and to propose new and improved methods of risk assessment.
This prospective cohort study was conducted in the clinics and surgical wards of a tertiary hospital and involved 523 elderly patients over 60 years of age. Demographic, clinical, functional, and cognitive characteristics assessed between 48 and 72 h after admission were analyzed to investigate correlations with lengths of stay greater than 10 days. Univariate and multivariate analyses were performed, and in the final model, long-term probability scores were estimated for each variable.
Of the 523 patients studied, 33 (6.3%) remained hospitalized for more than 10 days. Multiple regression analysis revealed that both the presence of diabetes and the inability to perform chair-to-bed transfers (Barthel Index) remained significant risk predictors. Diabetes doubled the risk of prolonged hospital stays, while a chair-to-bed transfer score of 0 or 5 led to an eight-fold increase in risk.
In this study, we propose an easy method that can be used, after external validation, to screen for long-term risk (using diabetes and bed/chair transfer) as a first step in identifying hospitalized elderly patients who will require comprehensive assessment to guide prevention plans and rehabilitation programs.
本研究旨在确定导致住院时间延长的主要预测因素,并提出新的、改进的风险评估方法。
本前瞻性队列研究在一家三级医院的诊所和外科病房进行,共纳入 523 名 60 岁以上的老年患者。在入院后 48 至 72 小时内评估了人口统计学、临床、功能和认知特征,并分析其与住院时间超过 10 天的相关性。进行了单因素和多因素分析,并在最终模型中估计了每个变量的长期概率评分。
在 523 名研究患者中,有 33 名(6.3%)患者的住院时间超过 10 天。多因素回归分析显示,糖尿病的存在和无法进行床椅转移(巴氏指数)仍然是显著的风险预测因素。糖尿病使住院时间延长的风险增加了一倍,而床椅转移评分为 0 或 5 则使风险增加了八倍。
在这项研究中,我们提出了一种简单的方法,可在外部验证后用于筛选长期风险(使用糖尿病和床椅转移),作为识别需要全面评估的住院老年患者的第一步,以指导预防计划和康复计划。