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Effect of Frailty on Functional Gain, Resource Utilisation, and Discharge Destination: An Observational Prospective Study in a GEM Ward. 虚弱对功能增益、资源利用和出院目的地的影响:一项GEM病房的观察性前瞻性研究。
Q2 Medicine Pub Date : 2014-01-01 Epub Date: 2014-02-17 DOI: 10.1155/2014/357857
Sujatha Kawryshanker, Warren Raymond, Katharine Ingram, Charles A Inderjeeth

Background. A geriatric evaluation and management unit (GEM) manages elderly inpatients with functional impairments. There is a paucity of literature on frailty and whether this impacts on rehabilitation outcomes. Objectives. To examine frailty score (FS) as a predictor of functional gain, resource utilisation, and destinations for GEM patients. Methods. A single centre prospective case study design. Participants (n = 136) were ≥65 years old and admitted to a tertiary hospital GEM. Five patients were excluded by the preset exclusion criteria, that is, medically unstable, severe dementia or communication difficulties after stroke. Core data included demographics, frailty score (FS), and functional independence. Results. The mean functional improvement (FIM) from admission to discharge was 11.26 (95% CI 8.87, 13.66; P < 0.001). Discharge FIM was positively correlated with admission FIM (β = 0.748; P < 0.001) and negatively correlated with frailty score (β = -1.151; P = 0.014). The majority of the patients were in the "frail" group. "Frail" and "severely frail" subgroups improved more on mean FIM scores at discharge, relative to that experienced by the "pre-frail" group. Conclusion. All patients experienced functional improvement. Frailer patients improved more on their FIM and improved relatively more than their prefrail counterparts. Higher frailty correlated with reduced independence and greater resource utilisation. This study demonstrates that FS could be a prognostic indicator of physical independence and resource utilisation.

背景。一个老年评估和管理单位(GEM)管理有功能障碍的老年住院患者。缺乏关于虚弱以及这是否会影响康复结果的文献。目标。检验衰弱评分(FS)作为GEM患者功能增益、资源利用和目的地的预测因子。方法。单中心前瞻性案例研究设计。参与者(n = 136)年龄≥65岁,在三级医院GEM就诊。5例患者被排除在预先设定的排除标准之外,即医学不稳定、严重痴呆或卒中后的沟通困难。核心数据包括人口统计、衰弱评分(FS)和功能独立性。结果。入院至出院的平均功能改善(FIM)为11.26 (95% CI 8.87, 13.66;P < 0.001)。出院FIM与入院FIM呈正相关(β = 0.748;P < 0.001),与衰弱评分呈负相关(β = -1.151;P = 0.014)。大多数患者属于“虚弱”组。“虚弱”和“严重虚弱”亚组在出院时的平均FIM评分比“虚弱前”组改善更多。结论。所有患者的功能均有改善。体弱患者的FIM改善更多,相对于体弱患者的改善更大。脆弱程度越高,独立性越低,资源利用率越高。本研究表明FS可以作为身体独立性和资源利用的预后指标。
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引用次数: 21
Factors Associated with Insomnia among Elderly Patients Attending a Geriatric Centre in Nigeria. 尼日利亚一家老年医学中心就诊的老年患者中与失眠有关的因素。
Q2 Medicine Pub Date : 2014-01-01 Epub Date: 2014-12-22 DOI: 10.1155/2014/780535
Adetola M Ogunbode, Lawrence A Adebusoye, Olufemi O Olowookere, Mayowa Owolabi, Adesola Ogunniyi

Background. Insomnia is a form of chronic sleep problem of public health importance which impacts the life of elderly people negatively. Methods. Cross-sectional study of 843 elderly patients aged 60 years and above who presented consecutively at Geriatric Centre, University College Hospital, Ibadan, Nigeria. The World Health Organization Composite International Diagnostic Interview was used to diagnose insomnia. We assessed the following candidate variables which may be associated with insomnia such as socidemographic characteristics, morbidities, and lifestyle habits. Statistical analysis was done with SPSS 17. Results. The point prevalence of insomnia was 27.5%. Insomnia was significantly associated with being female, not being currently married, having formal education, living below the poverty line, and not being physically active. Health complaints of abdominal pain, generalized body pain, and persistent headaches were significantly associated with insomnia. Conclusion. The high prevalence of insomnia among elderly patients in this setting calls for concerted effort by healthcare workers to educate the elderly on lifestyle modification.

背景。失眠是一种具有公共卫生意义的慢性睡眠问题,对老年人的生活造成了负面影响。研究方法对尼日利亚伊巴丹大学学院医院老年医学中心连续就诊的 843 名 60 岁及以上老年患者进行横断面研究。采用世界卫生组织的国际综合诊断访谈诊断失眠症。我们评估了以下可能与失眠有关的候选变量,如社会人口学特征、疾病和生活习惯。统计分析采用 SPSS 17 进行。结果失眠症的发病率为 27.5%。失眠与女性、未婚、受过正规教育、生活在贫困线以下以及不爱运动有很大关系。腹痛、全身疼痛和持续头痛等健康主诉与失眠有明显关联。结论在这种情况下,老年患者的失眠发生率很高,因此医护人员需要共同努力,教育老年人改变生活方式。
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引用次数: 0
The Prediction of ADL and IADL Disability Using Six Physical Indicators of Frailty: A Longitudinal Study in the Netherlands. 使用衰弱的六个物理指标预测ADL和IADL残疾:荷兰的一项纵向研究。
Q2 Medicine Pub Date : 2014-01-01 Epub Date: 2014-03-24 DOI: 10.1155/2014/358137
Robbert J J Gobbens, Marcel A L M van Assen

Frailty is a predictor of disability. A proper understanding of the contribution of individual indicators of frailty in the prediction of disability is a requisite for preventive interventions. The aim of this study was to determine the predictive power of the individual physical frailty indicators: gait speed, physical activity, hand grip strength, Body Mass Index (BMI), fatigue, and balance, for ADL and IADL disability. The sample consisted of 505 community-dwelling persons (≥75 years, response rate 35.1%). Respondents first participated between November 2007 and June 2008, and a subset of all respondents participated again one year later (N = 264, 52.3% response rate). ADL and IADL disability were assessed by the Groningen Activity Restriction Scale. BMI was assessed by self-report, and the other physical frailty indicators were assessed with the TUG test (gait speed), the LAPAQ (physical activity), a hand grip strength test, the SFQ (fatigue), and the Four-test balance scale. All six physical frailty indicators were associated with ADL and IADL disability. After controlling for previous disability, sociodemographic characteristics, self-perceived lifestyle, and chronic diseases, only gait speed was predictive of both ADL and IADL disability, whereas there was a small effect of fatigue on IADL disability. Hence, these physical frailty indicators should be included in frailty assessment when predicting future disability.

虚弱是残疾的前兆。正确了解个别脆弱指标在预测残疾方面的作用是预防性干预的必要条件。本研究的目的是确定个体身体虚弱指标:步态速度、身体活动、握力、体重指数(BMI)、疲劳和平衡对ADL和IADL残疾的预测能力。样本包括505名社区居民(≥75岁,应答率35.1%)。受访者首次参与是在2007年11月至2008年6月之间,所有受访者中的一部分在一年后再次参与(N = 264,回复率为52.3%)。采用格罗宁根活动限制量表评定ADL和IADL残疾。采用自我报告法评估BMI,其他身体虚弱指标采用TUG测试(步态速度)、LAPAQ(体力活动)、握力测试、SFQ(疲劳)和四项平衡量表进行评估。所有六项身体虚弱指标均与ADL和IADL残疾相关。在控制了既往残疾、社会人口统计学特征、自我感知的生活方式和慢性疾病后,只有步态速度能预测ADL和IADL残疾,而疲劳对IADL残疾的影响很小。因此,在预测未来残疾时,这些身体脆弱指标应包括在脆弱性评估中。
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引用次数: 68
Relationship-based care and behaviours of residents in long-term care facilities. 长期护理机构中以关系为基础的护理和居民行为。
Q2 Medicine Pub Date : 2014-01-01 Epub Date: 2014-01-12 DOI: 10.1155/2014/949180
Johanne Desrosiers, Anabelle Viau-Guay, Marie Bellemare, Louis Trudel, Isabelle Feillou, Anne-Céline Guyon

Introduction. In long-term care (LTC), person-centred approaches are encouraged. One such approach, relationship-based care (RBC), aims among other things to reduce residents' agitated behaviours. RBC has been used in numerous Quebec LTC facilities over the past decade but it has never been studied. Objective. Explore correlations between use of RBC by trained caregivers and the frequency of agitated and positive behaviours of residents with cognitive impairments. Methods. Two independent raters observed fourteen caregiver/resident dyads in two LTC facilities during assistance with hygiene and dressing. Checklists were used to quantify caregivers' RBC use and residents' agitated and positive behaviours. Results. Scores for RBC use were high, suggesting good application of the approach by caregivers. Correlation analyses showed that offering residents realistic choices and talking to them during care were associated with both positive and agitated behaviours (P from 0.03 to 0.003). However, many other components of RBC were not associated with residents' behaviours during care. Conclusions. There were only a few quantitative links between the RBC checklist items and the frequency of agitated or positive behaviours. Other studies with a more rigorous research design are needed to better understand the impact of relationship-based care on residents' behaviours.

介绍。在长期护理(LTC)中,鼓励采用以人为本的方法。以关系为基础的护理(RBC)就是其中一种方法,其目的之一是减少住户的激动行为。过去十年间,魁北克的许多长期护理机构都采用了 RBC,但从未对其进行过研究。研究目的探索受过培训的护理人员使用 RBC 与认知障碍住院患者的激动行为和积极行为频率之间的相关性。方法。两名独立的评分员观察了两家长期护理机构中 14 名护理员/住院患者在协助卫生和穿衣时的行为。使用核对表对护理人员使用 RBC 的情况以及住院患者的激动和积极行为进行量化。结果显示使用 RBC 的得分很高,表明护理人员很好地应用了这种方法。相关分析表明,为住院患者提供现实的选择以及在护理过程中与他们交谈与积极行为和激动行为有关(P 从 0.03 到 0.003)。然而,RBC 的许多其他组成部分与住院患者在护理期间的行为并无关联。结论RBC核对表项目与激动或积极行为的频率之间只有少数几个定量联系。要更好地了解以关系为基础的护理对住院患者行为的影响,还需要其他设计更加严谨的研究。
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引用次数: 0
The benefit of pets and animal-assisted therapy to the health of older individuals. 宠物和动物辅助疗法对老年人健康的好处。
Q2 Medicine Pub Date : 2014-01-01 Epub Date: 2014-11-16 DOI: 10.1155/2014/623203
E Paul Cherniack, Ariella R Cherniack

Many studies utilizing dogs, cats, birds, fish, and robotic simulations of animals have tried to ascertain the health benefits of pet ownership or animal-assisted therapy in the elderly. Several small unblinded investigations outlined improvements in behavior in demented persons given treatment in the presence of animals. Studies piloting the use of animals in the treatment of depression and schizophrenia have yielded mixed results. Animals may provide intangible benefits to the mental health of older persons, such as relief social isolation and boredom, but these have not been formally studied. Several investigations of the effect of pets on physical health suggest animals can lower blood pressure, and dog walkers partake in more physical activity. Dog walking, in epidemiological studies and few preliminary trials, is associated with lower complication risk among patients with cardiovascular disease. Pets may also have harms: they may be expensive to care for, and their owners are more likely to fall. Theoretically, zoonotic infections and bites can occur, but how often this occurs in the context of pet ownership or animal-assisted therapy is unknown. Despite the poor methodological quality of pet research after decades of study, pet ownership and animal-assisted therapy are likely to continue due to positive subjective feelings many people have toward animals.

许多研究利用狗、猫、鸟、鱼和机器人模拟动物,试图确定养宠物或动物辅助治疗对老年人的健康益处。几项小型非盲法调查概述了在动物在场的情况下接受治疗的痴呆症患者行为的改善。用动物试验治疗抑郁症和精神分裂症的研究结果喜忧参半。动物可能为老年人的心理健康提供无形的好处,例如缓解社会孤立和无聊,但这些尚未得到正式研究。几项关于宠物对身体健康影响的调查表明,动物可以降低血压,遛狗的人可以参与更多的体育活动。在流行病学研究和少数初步试验中,遛狗与心血管疾病患者并发症风险较低有关。宠物也可能有危害:照顾它们可能很昂贵,它们的主人更有可能摔倒。理论上,人畜共患感染和咬伤可能发生,但这种情况在宠物饲养或动物辅助治疗的情况下发生的频率尚不清楚。尽管经过几十年的研究,宠物研究的方法学质量很差,但由于许多人对动物有积极的主观感受,宠物饲养和动物辅助治疗可能会继续下去。
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引用次数: 130
Senescent remodeling of the innate and adaptive immune system in the elderly men with prostate cancer. 老年前列腺癌患者先天和适应性免疫系统的衰老重塑。
Q2 Medicine Pub Date : 2014-01-01 Epub Date: 2014-03-19 DOI: 10.1155/2014/478126
Gianluigi Taverna, Mauro Seveso, Guido Giusti, Rodolfo Hurle, Pierpaolo Graziotti, Sanja Stifter, Maurizio Chiriva-Internati, Fabio Grizzi

Despite years of intensive investigation that has been made in understanding prostate cancer, it remains a major cause of death in men worldwide. Prostate cancer emerges from multiple alterations that induce changes in expression patterns of genes and proteins that function in networks controlling critical cellular events. Based on the exponential aging of the population and the increasing life expectancy in industrialized Western countries, prostate cancer in the elderly men is becoming a disease of increasing significance. Aging is a progressive degenerative process strictly integrated with inflammation. Several theories have been proposed that attempt to define the role of chronic inflammation in aging including redox stress, mitochondrial damage, immunosenescence, and epigenetic modifications. Here, we review the innate and adaptive immune systems and their senescent remodeling in elderly men with prostate cancer.

尽管在了解前列腺癌方面进行了多年的深入调查,但它仍然是世界范围内男性死亡的主要原因。前列腺癌是由多种改变引起的基因和蛋白质表达模式的改变而产生的,这些基因和蛋白质在控制关键细胞事件的网络中起作用。在西方工业化国家,随着人口的指数老龄化和预期寿命的增加,老年男性前列腺癌正成为一种日益重要的疾病。衰老是一个与炎症紧密结合的渐进的退行性过程。已经提出了几种理论,试图定义慢性炎症在衰老中的作用,包括氧化还原应激、线粒体损伤、免疫衰老和表观遗传修饰。本文综述了老年前列腺癌患者的先天免疫系统和适应性免疫系统及其衰老重塑。
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引用次数: 18
Geriatric Hip Fractures and Inpatient Services: Predicting Hospital Charges Using the ASA Score. 老年髋部骨折和住院服务:使用ASA评分预测医院收费。
Q2 Medicine Pub Date : 2014-01-01 Epub Date: 2014-04-30 DOI: 10.1155/2014/923717
Rachel V Thakore, Young M Lee, Vasanth Sathiyakumar, William T Obremskey, Manish K Sethi

Purpose. To determine if the American Society of Anesthesiologist (ASA) score can be used to predict hospital charges for inpatient services. Materials and Methods. A retrospective chart review was conducted at a level I trauma center on 547 patients over the age of 60 who presented with a hip fracture and required operative fixation. Hospital charges associated with inpatient and postoperative services were organized within six categories of care. Analysis of variance and a linear regression model were performed to compare preoperative ASA scores with charges and inpatient services. Results. Inpatient and postoperative charges and services were significantly associated with patients' ASA scores. Patients with an ASA score of 4 had the highest average inpatient charges of services of $15,555, compared to $10,923 for patients with an ASA score of 2. Patients with an ASA score of 4 had an average of 45.3 hospital services compared to 24.1 for patients with a score of 2. Conclusions. A patient's ASA score is associated with total and specific hospital charges related to inpatient services. The findings of this study will allow payers to identify the major cost drivers for inpatient services based on a hip fracture patient's preoperative physical status.

目的。确定美国麻醉医师协会(ASA)评分是否可用于预测住院服务的医院收费。材料与方法。我们在一家一级创伤中心对547例60岁以上髋部骨折并需要手术固定的患者进行了回顾性分析。与住院和术后服务有关的医院收费按六类护理分类。方差分析和线性回归模型比较术前ASA评分与收费和住院服务。结果。住院和术后收费和服务与患者的ASA评分显著相关。ASA评分为4分的患者平均住院费用最高,为15,555美元,而ASA评分为2分的患者平均住院费用为10,923美元。ASA评分为4分的患者平均就诊45.3次,而评分为2分的患者平均就诊24.1次。结论。患者的ASA评分与住院服务相关的总费用和特定医院费用相关。这项研究的结果将允许付款人确定主要的成本驱动因素住院服务基于髋部骨折患者的术前身体状况。
{"title":"Geriatric Hip Fractures and Inpatient Services: Predicting Hospital Charges Using the ASA Score.","authors":"Rachel V Thakore,&nbsp;Young M Lee,&nbsp;Vasanth Sathiyakumar,&nbsp;William T Obremskey,&nbsp;Manish K Sethi","doi":"10.1155/2014/923717","DOIUrl":"https://doi.org/10.1155/2014/923717","url":null,"abstract":"<p><p>Purpose. To determine if the American Society of Anesthesiologist (ASA) score can be used to predict hospital charges for inpatient services. Materials and Methods. A retrospective chart review was conducted at a level I trauma center on 547 patients over the age of 60 who presented with a hip fracture and required operative fixation. Hospital charges associated with inpatient and postoperative services were organized within six categories of care. Analysis of variance and a linear regression model were performed to compare preoperative ASA scores with charges and inpatient services. Results. Inpatient and postoperative charges and services were significantly associated with patients' ASA scores. Patients with an ASA score of 4 had the highest average inpatient charges of services of $15,555, compared to $10,923 for patients with an ASA score of 2. Patients with an ASA score of 4 had an average of 45.3 hospital services compared to 24.1 for patients with a score of 2. Conclusions. A patient's ASA score is associated with total and specific hospital charges related to inpatient services. The findings of this study will allow payers to identify the major cost drivers for inpatient services based on a hip fracture patient's preoperative physical status. </p>","PeriodicalId":39066,"journal":{"name":"Current Gerontology and Geriatrics Research","volume":"2014 ","pages":"923717"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2014/923717","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32380992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 7
Predictors of Inpatient Utilization among Veterans with Dementia. 患有痴呆症的退伍军人使用住院治疗的预测因素。
Q2 Medicine Pub Date : 2014-01-01 Epub Date: 2014-05-29 DOI: 10.1155/2014/861613
Kyler M Godwin, Robert O Morgan, Annette Walder, David M Bass, Katherine S Judge, Nancy Wilson, A Lynn Snow, Mark E Kunik

Dementia is prevalent and costly, yet the predictors of inpatient hospitalization are not well understood. Logistic and negative binomial regressions were used to identify predictors of inpatient hospital utilization and the frequency of inpatient hospital utilization, respectively, among veterans. Variables significant at the P < 0.15 level were subsequently analyzed in a multivariate regression. This study of veterans with a diagnosis of dementia (n = 296) and their caregivers found marital status to predict hospitalization in the multivariate logistic model (B = 0.493, P = 0.029) and personal-care dependency to predict hospitalization and readmission in the multivariate logistic model and the multivariate negative binomial model (B = 1.048, P = 0.007, B = 0.040, and P = 0.035, resp.). Persons with dementia with personal-care dependency and spousal caregivers have more inpatient admissions; appropriate care environments should receive special care to reduce hospitalization. This study was part of a larger clinical trial; this trial is registered with ClinicalTrials.gov NCT00291161.

痴呆症发病率高、花费大,但住院治疗的预测因素却不甚了解。我们使用逻辑回归和负二项回归分别确定了退伍军人中住院病人使用率和住院病人使用频率的预测因素。在 P < 0.15 的水平上有意义的变量随后在多变量回归中进行了分析。这项针对被诊断患有痴呆症的退伍军人(n = 296)及其护理人员的研究发现,婚姻状况可在多变量逻辑模型中预测住院情况(B = 0.493,P = 0.029),而个人护理依赖可在多变量逻辑模型和多变量负二项模型中预测住院和再入院情况(B = 1.048,P = 0.007,B = 0.040,P = 0.035)。有个人护理依赖和配偶照顾者的痴呆患者住院人数较多;适当的护理环境应得到特别关注,以减少住院人数。本研究是一项大型临床试验的一部分;该试验已在 ClinicalTrials.gov NCT00291161 上注册。
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引用次数: 0
A Cross-Sectional Study to Examine Factors Associated with Primary Health Care Service Utilization among Older Adults in the Irbid Governorate of Jordan. 在约旦伊尔比德省,一项横断面研究旨在研究与老年人初级卫生保健服务利用相关的因素。
Q2 Medicine Pub Date : 2014-01-01 Epub Date: 2014-11-06 DOI: 10.1155/2014/735235
Abdullah Alkhawaldeh, Margo B Holm, Jamal Qaddumi, Wasileh Petro, Madi Jaghbir, Omar Al Omari

Background. Recently, the percentage of older adults in developing countries has increased significantly. Objective. This study examined patterns and factors associated with primary health care services utilization in the past 1, 6, and 12 months. Method. A cross-sectional study design was used to collect data from 190 older adults in the Irbid governorate of Jordan. Results. Primary health care services were used by less than half of the participants in the past 1 month, by 68.4% in the past 6 months, and by 73.8% in the past 12 months. Primary health care (PHC) services use was associated with age, education level, tobacco use, chronic illnesses, perceived general health status today, a physical component summary score, employment, and perceived general health status in the past 6 and 12 months. The primary predictor of PHC services use at 1, 6, and 12 months was chronic illnesses (OR = 13.32), (OR = 19.63), and (OR = 17.91), respectively. Conclusion. Although many factors were associated with PHC service utilization, the strongest predictor of PHC service utilization was chronic illnesses.

背景。最近,发展中国家老年人的比例显著增加。目标。本研究调查了过去1、6和12个月内与初级卫生保健服务利用相关的模式和因素。方法。横断面研究设计用于收集来自约旦伊尔比德省190名老年人的数据。结果。在过去1个月内使用初级卫生保健服务的参与者不到一半,在过去6个月内使用68.4%,在过去12个月内使用73.8%。初级卫生保健(PHC)服务的使用与年龄、教育水平、烟草使用、慢性疾病、当前感知的一般健康状况、身体成分总结得分、就业以及过去6个月和12个月的感知的一般健康状况有关。在第1、6和12个月时使用初级保健服务的主要预测因子分别是慢性疾病(OR = 13.32)、(OR = 19.63)和(OR = 17.91)。结论。虽然许多因素与初级保健服务的利用有关,但慢性疾病是初级保健服务利用的最强预测因子。
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引用次数: 33
The Simplified Acute Physiology Score III Is Superior to the Simplified Acute Physiology Score II and Acute Physiology and Chronic Health Evaluation II in Predicting Surgical and ICU Mortality in the "Oldest Old". 简化急性生理评分III优于简化急性生理评分II和急性生理与慢性健康评估II在预测“老年”患者手术和ICU死亡率方面。
Q2 Medicine Pub Date : 2014-01-01 Epub Date: 2014-02-17 DOI: 10.1155/2014/934852
Aftab Haq, Sachin Patil, Alexis Lanteri Parcells, Ronald S Chamberlain

Elderly patients in the USA account for 26-50% of all intensive care unit (ICU) admissions. The applicability of validated ICU scoring systems to predict outcomes in the "Oldest Old" is poorly documented. We evaluated the utility of three commonly used ICU scoring systems (SAPS II, SAPS III, and APACHE II) to predict clinical outcomes in patients > 90 years. 1,189 surgical procedures performed upon 951 patients > 90 years (between 2000 and 2010) were analyzed. SAPS II, SAPS III, and Acute APACHE II were calculated for all patients admitted to the SICU. Differences between survivors and nonsurvivors were analyzed using the Student's t-test and binary logistic regression analysis. A receiver operating characteristic (ROC) curve was constructed for each scoring system studied. The area under the ROC curve (aROC) for the SAPS III was 0.81 at a cut-off value of 57, whereas the aROC for SAPS II was 0.75 at a cut-off score of 44 and the aROC for APACHE II was 0.74 at a cut-off score of 13. The SAPS III ROC curve for prediction of hospital mortality exhibited the greatest sensitivity (84%) and specificity (66%) with a score of 57 for the "Oldest Old" population.

在美国,老年患者占所有重症监护病房(ICU)入院人数的26-50%。经过验证的ICU评分系统在预测“最老的老人”预后方面的适用性文献很少。我们评估了三种常用的ICU评分系统(SAPS II、SAPS III和APACHE II)预测> 90岁患者临床结局的效用。对951例90岁以上患者(2000年至2010年)的1189例外科手术进行了分析。计算SICU收治的所有患者的SAPS II、SAPS III和急性APACHE II。使用学生t检验和二元逻辑回归分析幸存者和非幸存者之间的差异。为每个评分系统构建受试者工作特征(ROC)曲线。SAPS III的ROC曲线下面积(aROC)为0.81,临界值为57,而SAPS II的aROC为0.75,临界值为44,APACHE II的aROC为0.74,临界值为13。预测住院死亡率的SAPS III ROC曲线表现出最高的敏感性(84%)和特异性(66%),“最老的老”人群的评分为57分。
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引用次数: 50
期刊
Current Gerontology and Geriatrics Research
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