Mixon Amanda S, Yeh Vivian M, Simmons Sandra, Powers James, Ely Eugene Wesley, Schnelle John, Vasilevskis Eduard E
Section of Hospital Medicine, Vanderbilt University Medical Center, Nashville, TN 37203, USA.
Geriatric Research Education and Clinical Center (GRECC), VA Tennessee Valley Healthcare System, Nashville, TN 37212, USA.
Geriatrics (Basel). 2019 Feb 9;4(1):19. doi: 10.3390/geriatrics4010019.
Geriatric syndromes and polypharmacy are common in older patients discharged to skilled nursing facilities (SNFs) and increase 30-day readmission risk. In a U.S.A. Department of Veterans Affairs (VA)-funded Quality Improvement study to improve care transitions from the VA hospital to area SNFs, Veterans (N = 134) were assessed for geriatric syndromes using standardized instruments as well as polypharmacy, defined as five or more medications. Warm handoffs were used to facilitate the transfer of this information. This paper describes the prevalence of geriatric syndromes, polypharmacy, and readmission rates. Veterans were prescribed an average of 14.7 medications at hospital discharge. Moreover, 75% of Veterans had more than two geriatric syndromes, some of which began during hospitalization. While this effort did not reduce 30-day readmissions, the high prevalence of geriatric syndromes and polypharmacy suggests that future efforts targeting these issues may be necessary to reduce readmissions among Veterans discharged to SNF.
老年综合征和多重用药在入住专业护理机构（SNFs）的老年患者中很常见，会增加30天再入院风险。在美国退伍军人事务部（VA）资助的一项旨在改善从VA医院到地区SNFs护理过渡的质量改进研究中，使用标准化工具对退伍军人（N = 134）进行了老年综合征以及多重用药（定义为服用五种或更多药物）评估。采用温馨交接方式促进这些信息的传递。本文描述了老年综合征、多重用药的患病率以及再入院率。退伍军人出院时平均服用14.7种药物。此外，75%的退伍军人患有两种以上老年综合征，其中一些在住院期间就已出现。虽然这项工作并未降低30天再入院率，但老年综合征和多重用药的高患病率表明，未来针对这些问题的努力对于减少入住SNFs的退伍军人再入院可能是必要的。
