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住院老年人评估与恢复项目背景下功能改善、住院时间及出院目的地的预测因素

Predictors of Functional Improvement, Length of Stay, and Discharge Destination in the Context of an Assess and Restore Program in Hospitalized Older Adults.

作者信息

Edelstein Beatrise, Scandiffio Jillian

机构信息

Humber River Hospital, Toronto, ON M3M 0A7, Canada.

出版信息

Geriatrics (Basel). 2022 Apr 20;7(3):50. doi: 10.3390/geriatrics7030050.

Abstract

Assess and restore programs such as Humber's Elderly Assess and Restore Team (HEART) provide short-term restorative care to prevent functional decline in hospitalized older adults. The aim of this retrospective observational study was to determine which HEART participant characteristics are predictive of functional improvement, decreased length of stay, return to home, and decreased readmission to hospital. Electronic health records were retrospectively examined to gather predictor data. Differences in functional status, excessive length of stay, discharge destination, and hospital readmissions were compared in 547 HEART patients and 547 matched eligible non-participants using ANOVAs, Mann-Whitney, and chi-square tests. The greatest functional improvements (percent Barthel change) were seen in those requiring a one-person assist (M = 39.56) and using a walker (M = 46.07). Difference in excessive length of stay between HEART and non-HEART participants was greatest in those who used a walker (Mdn = 3.80), required a one-person assist (Mdn = 2.00), had a high falls risk (Mdn = 1.80), and had either a lower urinary tract infection (Mdn = 2.25) or pneumonia (Mdn = 1.70). Predictor variables did not affect readmission to the hospital nor return to home. Predictive characteristics should be considered when enrolling patients to assess and restore programs for optimal clinical outcomes.

摘要

诸如汉伯老年评估与恢复团队(HEART)之类的评估与恢复项目为住院老年患者提供短期恢复性护理,以防止其功能衰退。这项回顾性观察研究的目的是确定HEART项目参与者的哪些特征可预测功能改善、缩短住院时间、回家以及减少再次入院。对电子健康记录进行回顾性检查以收集预测数据。使用方差分析、曼-惠特尼检验和卡方检验,比较了547名HEART患者和547名匹配的合格非参与者在功能状态、住院时间过长、出院目的地和再次入院方面的差异。在需要一人协助(M = 39.56)和使用助行器(M = 46.07)的患者中,观察到最大的功能改善(巴氏指数变化百分比)。HEART参与者与非参与者之间住院时间过长的差异在使用助行器(中位数 = 3.80)、需要一人协助(中位数 = 2.00)、跌倒风险高(中位数 = 1.80)以及患有下尿路感染(中位数 = 2.25)或肺炎(中位数 = 1.70)的患者中最为显著。预测变量对再次入院或回家没有影响。在招募患者参加评估与恢复项目时,应考虑预测特征以实现最佳临床结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4fe3/9149926/8dd815d3c7d2/geriatrics-07-00050-g001.jpg

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