Hospitalization-Associated Disability in Adults Admitted to a Safety-Net Hospital
Hospitalization-Associated Disability in Adults Admitted to a Safety-Net Hospital
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DOI：
10.1007/s11606-015-3395-2
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发表时间：
2015-12-01
影响因子：
5.7
通讯作者：
Pierluissi, Edgar
中科院分区：
文献类型：
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作者：
Chodos, Anna H.;Kushel, Margot B.;Pierluissi, Edgar
对在安全网医院接受护理的老年人的住院相关残疾 (HAD) 知之甚少。描述 HAD 并检查其与在安全网医院住院的 55 岁及以上成年人的年龄的关系。对出院干预试验的前瞻性队列的二次事后分析，从医院到家庭的老年人支持。安全网医院旧金山总医院的医学、心脏病学和神经病学住院服务。共有 583 名参与者 55 和会说英语、西班牙语或汉语的老年人。我们确定了住院后 30 天的 HAD 发生率以及按年龄组划分的 HAD 的 OR。结果指标是出院后 30 天的死亡或 HAD。 HAD 被定义为与基线相比，出院时出现的一项或多项日常生活活动 (ADL) 的新的或额外的残疾。参与者在基线（入院前 2 周）和出院后 30 天的功能状态通过 ADL 功能自我报告确定。许多参与者 (75.3%) 在基线时功能独立。按年龄组划分，HAD发生率如下：55-59岁为27.4%，60-64岁为22.2%，65-69岁为17.4%，70-79岁为30.3%，80岁及以上为61.7%。与最年轻的组相比，只有 80 岁以上成年人的 HAD 调整后 OR 显着，为 2.45（95% CI 1.17, 5.15）。 在安全网医院的成年人中，55-59 岁和 70-79 岁的成年人中 HAD 发生的比例相似，并且在最年长的成年人中最高，千分之 80。在安全网医院中，减少患者 HAD 的干预措施70 岁及以上人士应考虑将年龄标准扩大到 55 岁以下的成年人。
Little is known about hospitalization-associated disability (HAD) in older adults who receive care in safety-net hospitals.To describe HAD and to examine its association with age in adults aged 55 and older hospitalized in a safety-net hospital.Secondary post hoc analysis of a prospective cohort from a discharge intervention trial, the Support from Hospital to Home for Elders.Medicine, cardiology, and neurology inpatient services of San Francisco General Hospital, a safety-net hospital.A total of 583 participants 55 and older who spoke English, Spanish, or Chinese. We determined the incidence of HAD 30 days post-hospitalization and ORs for HAD by age group.The outcome measure was death or HAD at 30 days after hospital discharge. HAD is defined as a new or additional disability in one or more activities of daily living (ADL) that is present at hospital discharge compared to baseline. Participants' functional status at baseline (2 weeks prior to admission) and 30 days post-discharge was ascertained by self-report of ADL function.Many participants (75.3 %) were functionally independent at baseline. By age group, HAD occurred as follows: 27.4 % in ages 55-59, 22.2 % in ages 60-64, 17.4 % in ages 65-69, 30.3 % in ages 70-79, and 61.7 % in ages 80 or older. Compared to the youngest group, only the adjusted OR for HAD in adults over 80 was significant, at 2.45 (95 % CI 1.17, 5.15).In adults at a safety-net hospital, HAD occurred in similar proportions among adults aged 55-59 and those aged 70-79, and was highest in the oldest adults, aged a parts per thousand yen 80. In safety-net hospitals, interventions to reduce HAD among patients 70 years and older should consider expanding age criteria to adults as young as 55.