Effects of a modified Hospital Elder Life Program on frailty in individuals undergoing major elective abdominal surgery.
Effects of a modified Hospital Elder Life Program on frailty in individuals undergoing major elective abdominal surgery.
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DOI：
10.1111/jgs.12651
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发表时间：
2014-02
影响因子：
6.3
通讯作者：
Inouye SK
中科院分区：
文献类型：
--
作者：
Chen CC;Chen CN;Lai IR;Huang GH;Saczynski JS;Inouye SK
测试改良的医院老年生活计划（mHELP）对虚弱的影响。匹配和不匹配的数据分析，从一个前后研究。住院病人。年龄在65岁及以上的参与者（N = 189）在台湾的一家医疗中心接受择期腹部大手术。mHELP包括三个护理干预措施：早期动员，口腔和营养援助，定向沟通。从出院到出院后3个月的虚弱率和虚弱状态之间的转换，使用Fried表型标准分类为：非虚弱（存在0或1个标准）、虚弱前期（存在2或3个标准）和虚弱（存在4或5个标准）。在匹配的配对中，接受mHELP干预的参与者出院时虚弱的可能性显著低于其匹配的对照组（19.2% vs. 65.4%;调整后OR = 0.10，95% CI = 0.02至0.39）。在住院期间，对照组的参与者更容易过渡到更虚弱的状态。出院后3个月，住院期间接受mHELP干预的参与者比匹配的对照组更不容易虚弱（17.3% vs 23.1%;调整后OR = 0.73; 95% CI = 0.21至2.56），尽管这种差异没有达到统计学显著性。mHELP干预可有效降低出院时的虚弱程度，但在出院后3个月时获益减少。因此，mHELP提供了一个有用的方法来管理在医院虚弱的老年患者接受腹部大手术。
To test the effects of a modified Hospital Elder Life Program (mHELP) on frailty. Matched and unmatched analyses of data from a before-and-after study. Hospital, inpatient. Participants aged 65 years and older ((N = 189) undergoing elective, major abdominal surgery at a medical center in Taiwan. The mHELP included three nursing interventions: early mobilization, oral and nutritional assistance, and orienting communication. Frailty rate and transitions between frailty states from hospital discharge to 3 months after discharge, using Fried's phenotype criteria categorized as: non-frail (0 or 1 criteria present), pre-frail (2 or 3 criteria present), and frail (4 or 5 criteria present). Among matched pairs, participants who received the mHELP interventions were significantly less likely to be frail at discharge (19.2% vs. 65.4% for controls; adjusted OR = .10, 95% CI = .02 to .39) than their matched controls. Transitions to states of greater frailty during hospitalization were more common for participants in the control group. At 3 months post-discharge, participants who received the mHELP intervention during hospitalization were less likely to be frail than the matched controls (17.3% versus 23.1%; adjusted OR = .73; 95% CI = .21 to 2.56), although this difference did not achieve statistical significance. The mHELP intervention is effective in reducing frailty by hospital discharge but the benefit is diminished by 3 months post-discharge. Thus, the mHELP provides a useful approach to manage in-hospital frailty for older patients undergoing major abdominal surgery.
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影响因子：
158.5
作者：
Inouye, SK;Bogardus, ST;Cooney, LW
通讯作者：
Cooney, LW
DOI：
10.1016/j.jamcollsurg.2011.05.004
发表时间：
2011-08-01
影响因子：
5.2
作者：
Chen, Cheryl Chia-Hui;Lin, Ming-Tsan;Inouye, Sharon K.
通讯作者：
Inouye, Sharon K.
影响因子：
3.7
作者：
BHAPKAR, VP
通讯作者：
BHAPKAR, VP
影响因子：
6.3
作者：
SteelFisher GK;Martin LA;Dowal SL;Inouye SK
通讯作者：
Inouye SK
影响因子：
120.7
作者：
TINETTI, ME;INOUYE, SK;DOUCETTE, JT
通讯作者：
DOUCETTE, JT