烧伤专科护理中的衰弱筛查实践——多中心回顾性队列研究

IF 1 Q4 CRITICAL CARE MEDICINE European burn journal Pub Date : 2023-02-13 DOI:10.3390/ebj4010009
C. Cords, C. H. van der Vlies, M. Stoop, M. Nieuwenhuis, K. Boudestein, F. Mattace-Raso, M. V. van Baar
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摘要

背景:虚弱会对老年烧伤患者的预后产生负面影响。自2012年以来,荷兰医院一直使用荷兰安全管理系统(DSMS)的四域虚弱筛查工具。然而,其可行性和有效性却鲜有研究。我们的目的是评估虚弱筛查在烧伤专科护理中的可行性和有效性。方法:在荷兰所有烧伤中心进行多中心回顾性队列研究。患者年龄≥70岁,首次入院时间为2012-2018年。数据来源于电子病历。结果:共纳入515例患者。39.6%的患者完成虚弱筛查,23.9%的患者部分完成虚弱筛查。完整筛查的决定因素是2015年后入院(OR = 2.15, 95% CI 1.42-3.25)和较低的TBSA烧伤百分比(OR = 0.12, 95% CI 0.05-029)。在所有完全筛查的患者中,49.9%有虚弱的风险。有风险的患者年龄较大,合并症较多(已知的组效度),住院时间较长,并且更频繁地非家庭出院(预测效度)。结论:虚弱筛查在烧伤专科护理中是可行的,63.5%的住院患者进行了虚弱筛查。总的来说,44%的筛查患者有虚弱的风险。虚弱筛查的有效性得到了证实。虚弱筛查有助于最佳的专门烧伤护理。
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Frailty Screening Practice in Specialized Burn Care—A Retrospective Multicentre Cohort Study
Background: Frailty can have a negative influence on outcomes in elderly patients after burn injuries. The Dutch hospitals have used a four-domain frailty screening instrument from the Dutch Safety Management System (DSMS) since 2012. However, its feasibility and validity have hardly been studied. We aim to assess the feasibility and validity of frailty screening in specialized burn care. Methods: A multicentre retrospective cohort study was conducted in all Dutch burn centres. Patients aged ≥ 70, with a primary admission between 2012–2018, were included. Data were derived from electronic patient files. Results: In total, 515 patients were included. Frailty screening was complete in 39.6% and partially complete in 23.9%. Determinants for a complete screening were admission after 2015 (OR = 2.15, 95% CI 1.42–3.25) and lower percentage TBSA burned (OR = 0.12, 95% CI 0.05–029). In all completely screened patients, 49.9% were at risk of frailty. At risk patients were older, had more comorbidities (known group validity), a longer length of stay, and more frequently a non-home discharge (predictive validity). Conclusion: Frailty screening in specialized burn care is feasible and was conducted in 63.5% of admitted patients. In total, 44% of screened patients were at risk of frailty. Validity of frailty screening was confirmed. Frailty screening can contribute to optimal specialized burn care.
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