Bui James Huylam, Ngian Vincent J J, Tran Fiona, Scott Kirralee, Ngai Ka Chi, Ong Bin S
South Western Sydney Clinical Campus, School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia.
South Western Sydney Clinical Campus, School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia; and Department of Medical Assessment Unit, South Western Sydney Local Health District, Bankstown-Lidcombe Hospital, Sydney, NSW, Australia; and Department of Aged Care and Rehabilitation, South Western Sydney Local Health District, Bankstown-Lidcombe Hospital, Sydney, NSW, Australia.
Aust Health Rev. 2024 Nov;49. doi: 10.1071/AH24280.
Objectives Frailty is associated with significant mortality and morbidity in hospitalised patients. We describe physiotherapy and occupational therapy practices in hospitalised frail patients and examine the role of early intervention. Methods We performed a prospective, observational cohort study in a medical assessment unit in a tertiary care hospital. Patients with COVID-19 infection were excluded. Frailty was measured by the Clinical Frailty Scale (CFS). Early allied health intervention was defined as involvement within 48h of admission. Demographic data, clinical diagnoses, time spent with physiotherapy and occupational therapy, CFS, hospital length of stay and outcomes were recorded and analysed. Results A total of 356 patients were categorised into non-frail (CFS score <5) and frail (CFS score ≥5) groups. The prevalence of frailty was 68% (n =241). Physiotherapy (77.2%) and occupational therapy (75.5%) reviews were more frequent in frail patients than in non-frail patients. Frail patients who had allied health involvement within 48h of admission had a significant reduction in their hospital length of stay (mean reduction of 7.3days, 95% CI: 0.53, 14, P =0.035) and a 2.44% reduction in the relative risk of developing pressure injuries (95% CI: 1.31, 4.53). There was no statistically significant differences in outcomes with allied health intervention for non-frail patients and patients who require residential aged care facility level care. Conclusions Allied health have a key role in the management of frailty. Early allied health intervention was associated with a reduced hospital length of stay as well as a reduced incidence of pressure injury in frail patients.
衰弱与住院患者的高死亡率和高发病率相关。我们描述了住院衰弱患者的物理治疗和职业治疗实践，并探讨了早期干预的作用。方法：我们在一家三级护理医院的医疗评估单元进行了一项前瞻性观察队列研究。排除新型冠状病毒肺炎感染患者。采用临床衰弱量表（CFS）测量衰弱程度。早期联合健康干预定义为入院后48小时内参与。记录并分析人口统计学数据、临床诊断、接受物理治疗和职业治疗的时间、CFS、住院时间和结局。结果：共有356例患者被分为非衰弱组（CFS评分<5）和衰弱组（CFS评分≥5）。衰弱的患病率为68%（n =241）。与非衰弱患者相比，衰弱患者接受物理治疗（77.2%）和职业治疗（75.5%）评估的频率更高。入院后48小时内接受联合健康干预的衰弱患者住院时间显著缩短（平均缩短7.3天，95%CI：0.53，14，P =0.035），发生压疮的相对风险降低2.44%（95%CI：1.31，4.53）。对于非衰弱患者和需要入住老年护理机构级护理的患者，联合健康干预在结局方面没有统计学显著差异。结论：联合健康在衰弱管理中起着关键作用。早期联合健康干预与衰弱患者住院时间缩短以及压疮发生率降低相关。
