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医生与护士在mSEGA工具用于衰弱诊断方面的一致性。

Concordance in mSEGA Tool to Frailty Diagnosis between Medical Doctors and Nurses.

作者信息

Zulfiqar Abrar-Ahmad, Dembélé Ibrahima Amadou

机构信息

Department of Internal Medicine, University Hospital of Strasbourg, 67000 Strasbourg, France.

出版信息

Medicines (Basel). 2021 Oct 29;8(11):63. doi: 10.3390/medicines8110063.

Abstract

It is currently considered that screening for frailty in elderly subjects is a major public health issue. a cross-sectional pilot study involving elderly subjects (over 75 years of age) admitted at the emergency department of the hospital of Troyes, France in the period from 24 August to 30 August 2017 was conducted. The patients were screened for frailty using the modified SEGA (Short Emergency Geriatric Assessment) (part A) grid (mSEGA), correlated with the subjective opinion of the triage nurse and the senior physician. 100 patients were included during the pilot study period, the mean age was 84.34 years (range: 75-97), 56 patients (56%) were female, and the average CHARLSON score was 4.28 (range: 0-11). The patients' previous medical histories were remarkable for cardiovascular diseases. The main reason for hospital admission was fall (26 subjects, 26%). Hospitalization was required for 52 subjects (52%). The average mSEGA score was 6.3 +/- 3.59. The completion time for the SEGAm (part A) score was about 5 minutes. According to Cohen's kappa, the concordance between the subjective opinion of the triage nurse and the mSEGA grid was average, while the concordance between the subjective opinions of the senior physicians was good. The mSEGA score appears to be well-suited and useful in the emergency department. It is easy to use, allows an overall evaluation of the patient, and is not time-consuming.

摘要

目前认为,对老年受试者进行衰弱筛查是一个重大的公共卫生问题。我们开展了一项横断面试点研究,纳入了2017年8月24日至8月30日期间在法国特鲁瓦市医院急诊科就诊的老年受试者(75岁以上)。使用改良的SEGA(简易急诊老年评估)(A部分)网格(mSEGA)对患者进行衰弱筛查,并与分诊护士和 senior physician的主观意见相关联。在试点研究期间共纳入100例患者,平均年龄为84.34岁(范围:75 - 97岁),56例患者(56%)为女性,平均查尔森评分为4.28(范围:0 - 11)。患者既往病史以心血管疾病为主。入院的主要原因是跌倒(26例,26%)。52例患者(52%)需要住院治疗。mSEGA平均评分为6.3 +/- 3.59。SEGAm(A部分)评分的完成时间约为5分钟。根据科恩kappa系数,分诊护士的主观意见与mSEGA网格之间的一致性为中等,而 senior physicians的主观意见之间的一致性良好。mSEGA评分在急诊科似乎很适用且有用。它易于使用,能够对患者进行全面评估,并且不耗时。

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