A comprehensive evaluation of elderly people discharged from an Emergency Department
A comprehensive evaluation of elderly people discharged from an Emergency Department
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DOI：
10.1007/s11739-008-0151-1
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发表时间：
2008-09-01
影响因子：
4.6
通讯作者：
Vergani, Carlo
中科院分区：
文献类型：
--
作者：
Ballabio, Claudia;Bergamaschini, Luigi;Vergani, Carlo
老年人大量使用急诊室（艾德）。从艾德出院后，这些患者短期不良结局的风险很高，如功能下降、再次入住艾德、住院和死亡。我们调查了对从艾德出院的老年人进行全面的老年医学评估（CGE）和随访是否能为他们提供更好的诊断和治疗，从而减少不良结局。在423例75岁以上的老年患者出院的艾德，我们评估了其中的222人。根据身体、功能、认知和情绪状态的测试，对患者进行评估和治疗。比较基线和3个月后的量表评分。我们观察到所有研究患者的身体和情绪状态都有显着改善，认知功能障碍老年患者的行为状态有显着改善，认知功能障碍和行为障碍老年患者的照顾者的痛苦减少。我们还发现，艾德再入院或住院率低于CGE前3个月。老年患者的经验与艾德系统可以大大改善，如果他们的复杂的需求给予应有的重视，通过开发跨学科的项目之间的急诊医生，老年病学家，和初级保健医生。
Elderly people make extensive use of the Emergency Department (ED). After discharge from the ED, these patients are at high risk of short-term adverse outcomes such as functional decline, readmission to the ED, hospitalization and death. We investigated whether a comprehensive geriatric evaluation (CGE) and follow-up of the elderly discharged from the ED can provide them with better diagnosis and treatment, and thus reduce adverse outcomes. Out of 423 elderly patients over 75 years of age discharged from an ED we evaluated 222 of them. The patients were evaluated and treated, based on testing for physical, functional, cognitive and emotional status. A comparison was made between scale scores at baseline and 3 months later. We observed a significant improvement in physical and emotional status in all the studied patients, a significant improvement in behavioural status in the elderly patients with cognitive dysfunction, and a reduction of distress in the caregivers of the elderly patients with cognitive dysfunction and behavioural disturbances. We also found that the rate of ED readmission or hospitalization was lower than in the 3 months preceding the CGE. The experience of older patients with the ED system can be greatly improved if their complex needs are given due attention by developing interdisciplinary programs between emergency physicians, geriatricians, and primary care physicians.