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本文引用的文献

1
Examining the relationship between triage acuity and frailty to inform the care of older emergency department patients: Findings from a large Canadian multisite cohort study.探讨分诊 acuity 与虚弱之间的关系，以为老年急诊科患者的护理提供信息：来自加拿大多中心大型队列研究的结果。
CJEM. 2020 Jan;22(1):74-81. doi: 10.1017/cem.2019.432.
2
Association of Informal Caregiver Distress with Health Outcomes of Community-Dwelling Dementia Care Recipients: A Systematic Review.照料者负担与社区居住的痴呆症照料接受者健康结局的关系：系统评价。
J Am Geriatr Soc. 2019 Mar;67(3):609-617. doi: 10.1111/jgs.15690. Epub 2018 Dec 10.
3
Characterizing Highly Frequent Users of a Large Canadian Urban Emergency Department.描述加拿大大型城市急诊部门的高频使用者特征。
West J Emerg Med. 2018 Nov;19(6):926-933. doi: 10.5811/westjem.2018.9.39369. Epub 2018 Oct 18.
4
An Approach to the Older Patient in the Emergency Department.急诊科老年患者处理方法。
Clin Geriatr Med. 2018 Aug;34(3):299-311. doi: 10.1016/j.cger.2018.03.001. Epub 2018 Jun 11.
5
Repeat emergency department visits by nursing home residents: a cohort study using health administrative data.养老院居民的急诊重复就诊：使用健康管理数据的队列研究。
BMC Geriatr. 2018 Jul 5;18(1):157. doi: 10.1186/s12877-018-0854-8.
6
Identification of older adults with frailty in the Emergency Department using a frailty index: results from a multinational study.使用衰弱指数在急诊科识别衰弱的老年人：一项多国研究的结果。
Age Ageing. 2018 Mar 1;47(2):242-248. doi: 10.1093/ageing/afx168.
7
Association Between Spousal Caregiver Well-Being and Care Recipient Healthcare Expenditures.配偶照顾者的幸福感与受照顾者医疗保健支出之间的关联。
J Am Geriatr Soc. 2017 Oct;65(10):2220-2226. doi: 10.1111/jgs.15039. Epub 2017 Aug 24.
8
Frequent Use of Emergency Departments by the Elderly Population When Continuing Care Is Not Well Established.在持续护理尚未完善的情况下，老年人群频繁使用急诊科。
PLoS One. 2016 Dec 14;11(12):e0165939. doi: 10.1371/journal.pone.0165939. eCollection 2016.
9
Emergency department utilization by older adults: a descriptive study.老年人急诊科利用率：一项描述性研究。
Can Geriatr J. 2014 Dec 2;17(4):118-25. doi: 10.5770/cgj.17.108. eCollection 2014 Dec.
10
Geriatric emergency department guidelines.老年急诊科指南
Ann Emerg Med. 2014 May;63(5):e7-25. doi: 10.1016/j.annemergmed.2014.02.008.

老年急诊科患者：基线护理状态重要吗？

Older Emergency Department Patients: Does Baseline Care Status Matter?

作者信息

Mowbray Fabrice I, Aryal Komal, Mercier Eric, Heckman George, Costa Andrew P

机构信息

Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON.

Département de Médecine Familiale et Médecine d'Urgence, Faculté de Médecine, Université Laval, Quebec City, QC.

出版信息

Can Geriatr J. 2020 Dec 1;23(4):289-296. doi: 10.5770/cgj.23.421. eCollection 2020 Dec.

DOI:10.5770/cgj.23.421
PMID:33282049
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7704072/
Abstract

BACKGROUND

Little is known about the prognostic differences between older emergency department (ED) patients who present with different formal support requirements in the community. We set out to describe and compare the patient profiles and patterns of health service use among three older ED cohorts: home care clients, nursing home residents and those receiving no formal support.

METHODS

We conducted a secondary analysis of the Canadian cohort from the interRAI multinational ED study. Data were collected using interRAI ED contact assessment on patients 75 years of age and older (n = 2,274), in eight ED sites across Canada. A series of descriptive statistics were reported. Adjusted associations were determined using logistic regression.

RESULTS

Older adults receiving no formal support services were most stable. However, they were most likely to be hospitalized. Older home care clients were most likely to report depressive symptoms and distressed caregivers. They also had the greatest odds of frequent ED visitation post-discharge (OR=1.9; 95% CI=1.39-2.59). Older adults transferred from a nursing home were the frailest but had the lowest odds of hospital admission (OR=0.14; 95% CI=0.09-0.23).

CONCLUSION

We demonstrated the importance of inquiring about community-based formal support services and provide data to support decision-making in the ED.

摘要

背景

对于在社区中有不同正式支持需求的老年急诊科（ED）患者的预后差异，我们了解甚少。我们着手描述和比较三个老年急诊科队列中的患者概况及卫生服务使用模式：居家护理客户、养老院居民以及那些未接受正式支持的人群。

方法

我们对来自interRAI跨国急诊科研究的加拿大队列进行了二次分析。通过interRAI急诊科接触评估，收集了加拿大8个急诊科站点75岁及以上患者（n = 2274）的数据。报告了一系列描述性统计数据。使用逻辑回归确定调整后的关联。

结果

未接受正式支持服务的老年人最为稳定。然而，他们最有可能住院。老年居家护理客户最有可能报告抑郁症状且照顾者感到困扰。他们出院后频繁就诊急诊科的几率也最高（OR = 1.9；95% CI = 1.39 - 2.59）。从养老院转来的老年人最为虚弱，但住院几率最低（OR = 0.14；95% CI = 0.09 - 0.23）。

结论

我们证明了询问基于社区的正式支持服务的重要性，并提供数据以支持急诊科的决策制定。