Does home treatment affect delirium? A randomised controlled trial of rehabilitation of elderly and care at home or usual treatment (The REACH-OUT trial)
Does home treatment affect delirium? A randomised controlled trial of rehabilitation of elderly and care at home or usual treatment (The REACH-OUT trial)
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DOI：
10.1093/ageing/afi206
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发表时间：
2006-01-01
期刊：
影响因子：
6.7
通讯作者：
Woods, J
中科院分区：
文献类型：
--
作者：
Caplan, GA;Coconis, J;Woods, J
背景：谵妄是老年患者住院后常见的不良后果，但对其预防的研究很少。最近一项关于家庭医院（入院替代）的研究指出，家庭治疗组谵妄症状较少。地点：澳大利亚悉尼的一家三级转诊教学医院。方法：我们随机选取了104例连续转诊的老年康复患者，让他们在两种方式中接受治疗，一种是在家庭医院（早期出院），另一种是在康复病房。比较神志不清评定法测定的谵妄发生情况。次要结局指标为住院时间、住院天数、急性护理和康复费用、功能独立测量（FIM）、迷你精神状态检查（MMSE）和老年抑郁评分（GDS），分别在出院时和随访1个月和6个月时评估，以及患者满意度。结果：家庭组在康复期间发生谵妄的几率较低[比值比(OR) = 0.17；95%可信区间为0.03-0.65]，康复时间较短（15.97比23.09天，P = 0.0164），住院天数较少（20.31比40.09天，P = 0.0164）
Background: delirium is a frequent adverse consequence of hospitalisation for older patients, but there has been little research into its prevention. A recent study of Hospital in the Home (admission substitution) noted less delirium in the home-treated group.Setting: a tertiary referral teaching hospital in Sydney, Australia.Methods: we randomised 104 consecutive patients referred for geriatric rehabilitation to be treated in one of two ways, either in Hospital in the Home (early discharge) or in hospital, in a rehabilitation ward. We compared the occurrence of delirium measured by the confusion assessment method. Secondary outcome measures were length of stay, hospital bed days, cost of acute care and rehabilitation, functional independence measure (FIM), Mini-Mental State Examination (MMSE) and geriatric depression score (GDS) assessed on discharge and at 1- and 6-month follow-up and patient satisfaction.Results: the home group had lower odds of developing delirium during rehabilitation [odds ratio (OR) = 0.17; 95% confidence interval 0.03-0.65], shorter duration of rehabilitation (15.97 versus 23.09 days; P = 0.0164) and used less hospital bed days (20.31 versus 40.09, P