Factors Associated with Recovery of Activities of Daily Living in Elderly Pneumonia Patients
Factors Associated with Recovery of Activities of Daily Living in Elderly Pneumonia Patients
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DOI：
10.14442/general.16.68
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发表时间：
2015-06-01
影响因子：
1.6
通讯作者：
Yanagi, Hisako
中科院分区：
文献类型：
--
作者：
Goto, Ryohei;Watanabe, Hiroki;Yanagi, Hisako
背景：本研究旨在探讨住院期间接受康复治疗的老年肺炎患者日常生活能力（ADL）预后的相关因素。方法：该研究纳入因肺炎住院并在筑波纪念医院因废用综合征接受康复治疗的年龄≥65岁的患者。主要结果是使用功能独立测量（FIM）分数来评估 ADL。根据 FIM 恢复率评分将参与者分为高恢复组（>= 80%）和低恢复组（< 80%）。此外，使用多元逻辑回归分析评估与 ADL 预后相关的因素。评价项目包括基本特征、意识、常用交通方式、FIM评分、握力、活动范围、体位性低血压、运动耐量（6分钟步行距离）、呼吸障碍（Hugh-Jones分类）、便秘、营养不良（简易营养评估）、认知（简易精神状态检查）、抑郁（老年抑郁量表）、平衡（功能平衡量表）、尿失禁、压疮等。 结果：51例老年患者中患有肺炎的患者（平均年龄 +/- SD；82.0 +/- 11.3），34 名患者被分类为高恢复组，17 名患者被分类为低恢复组。多变量Logistic回归分析显示，从发病到开始康复的天数（不活动天数）和营养状况是与高恢复FIM评分相关的因素。结论：研究结果表明，住院后不活动天数和早期管理营养状况对于老年肺炎患者恢复ADL很重要。
Background: The current study aimed to investigate factors associated with the prognosis of activities of daily living (ADL) in elderly patients with pneumonia who had undergone rehabilitation during their hospitalization.Methods: The study included patients of age >= 65 years who were hospitalized due to pneumonia and had undergone rehabilitation for disuse syndrome at Tsukuba Memorial Hospital. The main outcome was measured using the functional independence measure (FIM) scores to assess ADL. The participants were divided into a high-recovery group (>= 80%) and a low-recovery group (< 80%) based on the FIM recovery rate score. Further, factors associated with the prognosis of ADL were evaluated using multivariate logistic regression analysis. Basic characteristics, consciousness, usual mode of transportation, FIM score, grip strength, range of motion, orthostatic hypotension, exercise tolerance (6-minutes walking distance), respiratory disorder (Hugh-Jones classification), constipation, malnutrition (mini-nutritional assessment), cognitive (mini-mental state examination), depression (geriatric depression scale), balance (functional balance scale), urinary incontinence, and pressure ulcers were included as the evaluation items.Results: Among the 51 elderly patients with pneumonia (average age +/- SD; 82.0 +/- 11.3), 34 patients were classified in the high-recovery group and 17 in the low-recovery group. In multivariate logistic regression analysis, it was revealed that the number of days from the onset until the initiation of rehabilitation (days of inactivity) and nutritional status were factors associated with a high-recovery FIM score.Conclusions: The study results suggest that days of inactivity and early management of nutritional status after hospitalization are important for elderly patients with pneumonia to return to their ADL.