与老年病人住院时间有关的因素。

Aging (Milan, Italy) Pub Date : 1999-06-01
A Di Iorio, A Longo, A Mitidieri Costanza, T Palmerio, E Benvenuti, S Giardini, A Bavazzano, G Guizzardi, U Senin, S Bandinelli, L Ferrucci, G Abate
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引用次数: 0

摘要

本研究的目的是评估预测老年病人住院时间的因素。研究对象是402名患者(183名男性,219名女性),分别住在意大利基耶蒂、佩鲁贾、佩斯卡拉和普拉托的四个老年病房。收集了关于逗留时间长短的潜在预测因素的信息;特别是,我们评估了特定慢性疾病的存在和严重程度、身体功能水平、认知状态和抑郁症状。此外,还获得了关于家庭和社会支助的资料。一般来说,参与者都是老年人,通常有认知障碍和身体残疾。平均住院时间从佩鲁贾的9.4 +/- 3.3天到基耶蒂的14.1 +/- 7.2天不等,各中心间差异有统计学意义(p < 0.001)。没有任何特定的医学诊断与不同的住院时间有关。然而,较高的合并症评分(p < 0.001)、独居(p < 0.01)、较低的MMSE评分(p = 0.03)和较差的功能状态(p = 0.05)均与较长的住院时间相关。当这些变量被包括在预测住院时间的多变量模型中时,中心之间的差异不再具有统计学意义。本研究结果表明,具体的医疗诊断是不够的工具,以估计在老年单位的停留时间。其他基于社会网络扩展、共病、认知和功能层面的评估系统有待开发。
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Factors related to the length of in-hospital stay of geriatric patients.

The aim of this study was to evaluate factors predicting length of stay in hospital of geriatric patients. Study participants were 402 patients (183 males and 219 females) consecutively admitted to four geriatric wards located in Chieti, Perugia, Pescara and Prato, Italy. Information on potential predictors of length of stay was collected; in particular, we assessed the presence and severity of specific chronic medical conditions, level of physical function, cognitive status, and depressive symptoms. Moreover, information on family and social support was obtained. In general, participants were old, often cognitively impaired and physically disabled. Average length of stay ranged from 9.4 +/- 3.3 days (Perugia) to 14.1 +/- 7.2 days (Chieti), and was statistically different across centers (p < 0.001). None of the specific medical diagnoses was associated with different length of stay. However, higher comorbidity score (p < 0.001), living alone (p < 0.01), lower MMSE score (p = 0.03), and poor functional status (p = 0.05) were all associated with longer length of stay. When these variables were included in a multivariate model predicting length of stay, differences between centers were no longer statistically significant. Findings of this study show that specific medical diagnoses are not adequate instruments to estimate length of stay in geriatric units. Other assessment systems based on extension of the social network, comorbidity, and the cognitive as well as the functional level need to be developed.

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