Geriatric assessment and intervention in an emergency department observation unit reduced re-attendance and hospitalisation rates
Geriatric assessment and intervention in an emergency department observation unit reduced re-attendance and hospitalisation rates
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DOI：
10.1111/j.1741-6612.2010.00499.x
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发表时间：
2012-03-01
影响因子：
1.6
通讯作者：
Seow, Eillyne
中科院分区：
文献类型：
--
作者：
Foo, Chik Loon;Siu, Vivian Wing Yin;Seow, Eillyne
目的：确定老年评估和干预在急诊科观察室（EDOU）的有效性。方法：这是一项单中心、治疗前/治疗后前瞻性研究。对照组给予常规EDOU护理。干预组在出院前接受老年医学评估和干预。术后3、6、9、12个月随访。终点包括通过电话获得的福尔斯和功能评分，以及通过电子记录获得的计划外艾德复诊和住院。结果：研究人群包括172名对照组和315名干预组患者。干预组中共有71.7%的患者存在需要干预的隐藏需求。干预组在12个月时的艾德再就诊率（调整后的发病率比（IRR）0.59，95%置信区间（CI）0.48-0.71）和住院率（调整后的IRR 0.64，95% CI 0.51-0.79）显著降低。结论：入住EDOU的老年患者是一个高危人群，出院前进行老年医学评估是有益的。
Aim: To determine the efficacy of geriatric assessment and intervention in an emergency department observation unit (EDOU). Methods: This was a single-centre, before/ after prospective study. The control group received the usual EDOU care. Intervention group received geriatric assessment and intervention before discharge. Patients were followed up at 3, 6, 9 and 12 months. End-points included falls and functional scores obtained via telephone, and unscheduled ED re-attendance and hospitalisation obtained through electronic records. Results: The study population included 172 control and 315 intervention group patients. A total of 71.7% of patients in the intervention group had hidden needs that required intervention. The intervention group had significantly less ED re-attendance (adjusted incidence rate ratio (IRR) 0.59, 95% confidence interval (CI) 0.48-0.71) and hospitalisation rates (adjusted IRR 0.64, 95% CI 0.51-0.79) at 12 months. Conclusion: Older patients admitted to an EDOU are an at-risk group and benefit from geriatric assessment before discharge.