Amsterdam University Medical Center, University of Amsterdam, Department of Internal Medicine, Section of Geriatric Medicine, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.
RE-FIT Barcelona research group, Parc Sanitari Pere Virgili and Vall d'Hebron Institute of Research (VHIR), Barcelona, Spain; Department of Medicine, Univeristat Autonoma de Barcelona, Barcelona, Spain.
J Am Med Dir Assoc. 2021 Jun;22(6):1228-1234. doi: 10.1016/j.jamda.2020.12.034. Epub 2021 Jan 29.
Throughout Europe, the number of older adults requiring acute hospitalization is increasing. Admission to an acute geriatric unit outside of a general hospital could be an alternative. In this model of acute medical care, comprehensive geriatric assessment and rehabilitation are provided to selected older patients. This study aims to compare patients' diagnoses, characteristics, and outcomes of 2 European sites where this care occurs.
Exploratory cohort study.
Subacute Care Unit (SCU), introduced in 2012 in Barcelona, Spain, and the Acute Geriatric Community Hospital (AGCH), introduced in 2018 in Amsterdam, the Netherlands. The main admission criteria for older patients were acute events or exacerbations of chronic conditions, hemodynamic stability on admission, and no requirement for complex diagnostics.
We compared setting, characteristics, and outcomes between patients admitted to the 2 units.
Data from 909 patients admitted to SCU and 174 to AGCH were available. Patients were admitted from the emergency department or from home. The mean age was 85.8 years [standard deviation (SD) = 6.7] at SCU and 81.9 years (SD = 8.5) (P < .001) at AGCH. At SCU, patients were more often delirious (38.7% vs 22.4%, P < .001) on admission. At both units, infection was the main admission diagnosis. Other diagnoses included heart failure or chronic obstructive pulmonary disease. Five percent or less of patients were readmitted to general hospitals. Average length of stay was 8.8 (SD = 4.4) days (SCU) and 9.9 (SD = 7.5) days (AGCH).
These acute geriatric units are quite similar and both provide an alternative to admission to a general hospital. We encourage the comparison of these units to other examples in Europe and suggest multicentric studies comparing their performance to usual hospital care.
在整个欧洲，需要急性住院治疗的老年人数量正在增加。将老年人收治到综合医院以外的急性老年病房可能是一种选择。在这种急性医疗模式中，为选定的老年患者提供全面的老年综合评估和康复治疗。本研究旨在比较发生这种护理的 2 个欧洲地点的患者诊断、特征和结局。
探索性队列研究。
亚急性护理病房（SCU）于 2012 年在西班牙巴塞罗那设立，急性老年社区医院（AGCH）于 2018 年在荷兰阿姆斯特丹设立。老年患者的主要入院标准为急性事件或慢性疾病恶化、入院时血流动力学稳定以及无需复杂诊断。
我们比较了 2 个单位的设置、特征和结果。
SCU 收治的 909 例患者和 AGCH 收治的 174 例患者的数据可用。患者从急诊室或家中被收治入院。SCU 患者的平均年龄为 85.8 岁（标准差[SD]=6.7），AGCH 患者的平均年龄为 81.9 岁（SD=8.5）（P<.001）。在 SCU，入院时患者谵妄的比例更高（38.7% vs 22.4%，P<.001）。在这 2 个病房，感染都是主要的入院诊断。其他诊断包括心力衰竭或慢性阻塞性肺疾病。不到 5%的患者被重新收住到综合医院。平均住院时间分别为 8.8（SD=4.4）天（SCU）和 9.9（SD=7.5）天（AGCH）。
这些急性老年病房非常相似，均为入住综合医院的替代方案。我们鼓励将这些病房与欧洲其他病房进行比较，并建议开展多中心研究，比较其与常规医院护理的疗效。
