Yonsei University College of Nursing, 50-1 Yonsei-Ro, Seodaemun-Gu, Seoul, 03722, South Korea.
Yonsei University College of Medicine, 50-1 Yonsei-Ro, Seodaemun-Gu, Seoul, 03722, South Korea.
Aging Clin Exp Res. 2020 Jun;32(6):1137-1143. doi: 10.1007/s40520-019-01300-9. Epub 2019 Aug 19.
Although pre-operative, Comprehensive Geriatric Assessment has been used widely, its impact on the health status of older adults has not been fully examined.
This study aimed to investigate the relationships between subcomponents of a Comprehensive Geriatric Assessment and length of hospital stay in older adults undergoing spinal surgery.
Participants were 133 older adults in neurosurgical department. The Comprehensive Geriatric Assessment included nutrition, physical activity, functional status, cognition, depression, the Timed Up and Go test, self-rated health, and frailty. Length of stay was replaced by excessive number of days, because expected length of stay varied depending on the type of surgery.
Excessive lengths of stay were associated with pre-frailty (p = 0.02), frailty (p = 0.02), risk of depression (p < 0.01), and post-operative complications (p < 0.01). More specifically, frailty and risk of depression played as moderators as interacting post-operative complications. The effect of interaction was greatest in the older adults who were frail and depressed (p < 0.001).
Among the subcomponent of Comprehensive Geriatric Assessment, frailty and depression were significant predictors of excessive length of stay. The interrelationship between frailty and depression better explained excessive length of stay rather than considered as individual variable.
Clinicians are encouraged to pay attention to depression and frailty, and its interaction to improve the health status of surgical elderly patients.
尽管术前综合老年评估已被广泛应用，但它对老年人健康状况的影响尚未得到充分研究。
本研究旨在探讨综合老年评估的各亚组分与老年人脊柱手术后住院时间的关系。
研究对象为神经外科的 133 名老年人。综合老年评估包括营养、身体活动、功能状态、认知、抑郁、计时起立行走测试、自我报告健康状况和虚弱程度。住院时间用超出天数来替代，因为预期的住院时间取决于手术类型。
住院时间延长与术前虚弱（p=0.02）、虚弱（p=0.02）、抑郁风险（p<0.01）和术后并发症（p<0.01）相关。更具体地说，虚弱和抑郁风险作为相互作用的术后并发症的调节剂。在虚弱和抑郁的老年人中，这种相互作用的影响最大（p<0.001）。
在综合老年评估的亚组分中，虚弱和抑郁是住院时间延长的显著预测因子。虚弱和抑郁之间的相互关系更好地解释了住院时间延长，而不是将其视为单个变量。
鼓励临床医生关注抑郁和虚弱及其相互作用，以改善老年手术患者的健康状况。
