Department of General Medicine, Fremantle Hospital and Health Service, Alma Street, Fremantle, WA 6160, Australia.
Age Ageing. 2021 Sep 11;50(5):1834-1839. doi: 10.1093/ageing/afab074.
A patient's self-reported health-related quality of life (HRQoL) can be quantified by a patient-reported outcome measure (PROM). A patient's HRQoL can provide another avenue to understand the 'post-hospital syndrome', a period after hospital discharge that a patient remains vulnerable to subsequent re-admission. The purpose of the study was to establish the feasibility of collecting HRQoL of older inpatients treated for acute illnesses on medical ward. Feasibility of the PROM would be qualitatively judged upon completion time, response rate and sensitivity to change in HRQoL over time.
A prospective observational cohort of consecutively admitted patients to a step-down medical ward over 1 year. The COOP/WONCA chart was the PROM. Patients were interviewed by the author face-to-face within 48 hours of admission and then 2 weeks after discharge by telephone.
From the 300 patients admitted, 182 were excluded. Of the remaining 118, median age was 78 years (interquartile range, IQR, 64-86 years), and 71 (60.2%) were female. Proxies were used for 26 (22%) patients. Ninety-two (78%) completed follow-up. The participants were contacted at a median of 14 days (IQR, 13-16) after discharge. Exploratory analyses found that the COOP/WONCA had test-retest responsiveness, that is detected change in HRQoL over time.
The completion time of 3 minutes, high response rate (78%) and test-retest responsiveness are evidence that collecting PROs from acutely unwell elderly patients using the COOP/WONCA is feasible. PRO research could become fundamental to the understanding of the 'post-hospital syndrome'.
患者自我报告的健康相关生活质量（HRQoL）可以通过患者报告的结果测量（PROM）来量化。患者的 HRQoL 可以提供另一种途径来理解“出院后综合征”，即患者出院后仍易再次入院的一段时间。本研究的目的是确定在医疗病房中治疗急性疾病的老年住院患者收集 HRQoL 的可行性。PROM 的可行性将根据完成时间、反应率和对随时间变化的 HRQoL 的敏感性进行定性判断。
对一个降阶梯医疗病房连续入院的患者进行前瞻性观察队列研究。COOP/WONCA 图表是 PROM。患者在入院后 48 小时内由作者进行面对面访谈，然后在出院后 2 周通过电话进行访谈。
在 300 名入院患者中，有 182 名被排除在外。在剩余的 118 名患者中，中位年龄为 78 岁（四分位距，IQR，64-86 岁），71 名（60.2%）为女性。有 26 名（22%）患者使用了代理人。92 名（78%）完成了随访。参与者在出院后中位数 14 天（IQR，13-16）时被联系。探索性分析发现，COOP/WONCA 具有测试重测反应性，即检测随时间变化的 HRQoL 变化。
完成时间为 3 分钟、高反应率（78%）和测试重测反应性表明，使用 COOP/WONCA 从急性不适的老年患者中收集 PRO 是可行的。PRO 研究可能成为理解“出院后综合征”的基础。
