老年综合评估在老年疾病预后中的应用效果

Effect of Comprehensive Geriatric Assessment Applied in the Prognosis of Geriatric Diseases

中文关键词: 老年  老年综合评估  老年医学  多学科团队  干预

英文关键词: elderly  geriatrics  multidisciplinary team  intervention

中文摘要:

      目的 探讨老年综合评估(CGA)对老年疾病预后的影响,以明确利用老年综合评估工具对老年患者实施长期干预管理的有效性和应用前景.方法 选取住院老年患者150例,随机分为观察组(n=80)和对照组(n=70).对照组给予CGA,观察组给予CGA及干预.2组均于入院时、入院后1个月和3个月时间点进行平衡测试与步态测试、MORSE评分、ADL和IADL评分,以及评估多重用药情况等,并对2组结果进行统计学分析和比较.结果 观察组入院后1个月和3个月平衡+步态评分(18.7±4.6、19.1±3.7)均明显高于较对照组(16.9±5.3、16.2±4.9) (P＜0.05、P＜0.01);观察组入院后1个月和3个月MORSE评分(51.7±6.4、50.4±7.2)均显著低于对照组(53.8±5.7、53.5±6.8)(P＜0.05、P＜0.01);表明观察组患者衰弱与跌倒比对照组患者改善更明显.观察组入院后1个月和3个月ADL评分(74.22±16.73、78.62±17.43)均明显高于对照组(66.74±16.92、63.84±15.62)(P＜0.01、P＜0.001);观察组入院后1个月和3个月IADL评分(6.35±1.55、6.58±1.62)显著高于对照组(5.66± 1.58、5.22±1.46)(P＜0.01、P＜0.001),提示观察组的功能状态比对照组明显好转.观察组入院后1个月多重用药(6.54±1.32)明显少于对照组(7.37±1.58)(P＜0.001),表明观察组的用药情况优于对照组.结论 CGA技术应用对老年疾病预后改善有效果,将CGA纳入老年病管理程序,可使老年衰弱、共病和失能的患者受益,可望在临床上推广应用.

英文摘要:

      Objective To explore the effect of comprehensive geriatric assessment (CGA) on the prognosis of geriatric diseases so as to make clear the effectiveness of CGA application on long-term intervention management of elderly patients and the application prospect.Methods 150 hospitalized elderly patients were selected and randomly divided into 2 groups:observation group (n =80) and control group (n =70);CGA was applied to patients in both groups while certain interventions were added to patients in observation group;at the time point of admission,1 month and 3 months after admission,balance test,gait test,MORSE score,ADL and IADL score and evaluation of polypharmacy were performed in the 2 groups,and statistical comparison and analysis were made.Results The scores of balance test and gait tests of the patients in observation group at the time point of 1 month and 3 months after admission (18.7±4.6,19.1 ±3.7) were much higher than those of the patients in control group (P＜0.05,P＜0.01);the MORSE scores of the patients in observation group at the time point of 1 month and 3 months after admission (51.7±6.4,50.4±7.2) were much lower than those (53.8±5.7,53.5±6.8) of the patients in control group (P＜ 0.05、P＜ 0.01),which indicated that the improvement of the patients in observation group in weakness and falling down was superior to that of the patients in control group;the ADL scores of the patients in observation group at the time point of 1 month and 3 months after admission (6.35 ± 1.55,6.58 ± 1.62) were obviously higher than those of the patients in control group (5.66± 1.58、5.22± 1.46) (P＜0.05、P＜0.01),which indicated that the improvement of function in observation group was much bigger than that in control group;the polypharmacy in observation group was superior to that in control group.Conclusions The application of CGA is effective in the improvement of prognosis of geriatric diseases;to bring CGA into the management system of geriatric diseases is beneficial for elderly patients with weakness,comorbidity and disability and is worthy of wide clinical application.