Predictive factors for early unplanned rehospitalization of older adults after an ED visit: role of the caregiver burden
Predictive factors for early unplanned rehospitalization of older adults after an ED visit: role of the caregiver burden
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DOI：
10.1007/s40520-015-0347-y
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发表时间：
2015-12-01
影响因子：
4
通讯作者：
Gentile, Stephanie
中科院分区：
文献类型：
--
作者：
Bonin-Guillaume, Sylvie;Durand, Anne-Claire;Gentile, Stephanie
对于老年人来说，急诊室（艾德）访问代表了一段时间的脆弱性，超出了访问本身。本研究的目的是确定照顾者的作用，和老年条件的患者早期计划外再住院（EUR）后3个月内艾德visit.This前瞻性纵向实验研究包括连续173例75岁及以上的患者在艾德超过2周的时间（18.7%的总访问）。仅分析了有看护者的老年患者（78.0%，n = 135）。记录每位患者的医疗状况和全面的老年评估。所有的照顾者进行了采访，他们的任务和情绪的影响，使用短Zarit负担清单。三个月后，患者或其照顾者被要求了解患者的生命状态和EUR。在纳入的患者中，64.2%有EUR，28.9%的照顾者报告了高水平的负担。EUR与高护理者负担密切相关（OR 8.7，95%CI 1.5-49.8）。未发现与患者的医疗或老年状态相关。照顾者报告了显着的高负担时，病人营养不良，或在不良的健康后果的风险的基础上的ISAR量表，当他们有更大的残疾在IADL和ADL，或认知implementations.Many医院再入院后，艾德访问可以通过识别照顾者的高负担来预防。导致这种高负担的原因应在首次访视时检查。
For older adults, an Emergency Department (ED) visit represents a period of vulnerability that extends beyond the visit itself. This study aimed to determine the impact of the role of caregiver, and geriatric conditions of patients on early unplanned rehospitalization (EUR) within 3 months after an ED visit.This prospective longitudinal experimental study included consecutively 173 patients aged 75 and older admitted in an ED over a 2-week period (18.7 % of the total visits). Only older patients having a caregiver were analyzed (78.0 %, n = 135). Medical conditions and a comprehensive geriatric assessment were recorded for each patient. All caregivers were interviewed about their tasks and emotional impact using the short Zarit Burden Inventory. Three months after, patients or their caregivers were called about the vital status, and EUR of patients.Among the patients included, 64.2 % had an EUR and 28.9 % of their caregivers reported a high level of burden. EUR was strongly associated with a high caregiver burden (OR 8.7, 95 % CI 1.5-49.8). No association was found for patient's medical or geriatric status. Caregivers reported a significantly high burden when patients were malnourished, or were at risk of adverse health outcomes based on the ISAR scale, and when they had greater disabilities in IADLs and ADLs, or cognitive impairments.Many hospital readmissions after an ED visit may be preventable by identifying caregiver's high burden. Reasons that lead to this high burden should be checked at the first visit.