{"title":"在肺部疾病中心住院的75岁及以上患者的老年护理相关结果和医院相关并发症的预测因子","authors":"Daniela Josefina Cataneo‐Piña, Celia Gabriela Hernández‐Favela, Lidia Aurora Mondragón‐Posadas, Citlalic Torres Nuñez","doi":"10.1002/agm2.12271","DOIUrl":null,"url":null,"abstract":"Abstract Objective The primary aim of this study was to evaluate the influence of targeted interventions, administered through comprehensive geriatric assessments on the incidence of hospitalization‐related complications among older adults diagnosed with pulmonary diseases. Methods A retrospective analysis of medical records encompassed individuals aged 75 years and older who were admitted to a lung center during the period spanning from March to June 2023. These admissions occurred in a context where standardized geriatric management protocols were systematically implemented. This study's scope extended to assessing the prevalence of hospital‐related complications, encompassing delirium and pressure ulcers. A rigorous multivariate logistic regression analysis was conducted to discern and characterize associated factors. Results The integration of comprehensive geriatric assessment yielded a substantial reduction in in‐hospital complications among the cohort of 118 patients (mean age : 82.1 ± 5.6 years, 44.5% women). The incidence of delirium decreased from 53.3% to 21.8% [odds ratio (OR): 0.246, 95% confidence interval (CI): 0.134–0.450, p < 0.001], whereas the presence of pressure ulcers decreased from 43.9% to 25% (OR: 0.395, 95% CI: 0.217–0.715, p < 0.001). The multivariate analysis uncovered independent associations between delirium and variables including community‐acquired pneumonia (OR: 4.417, 95% CI : 1.574–12.395, p = 0.005), severe disability (OR: 2.981, 95% CI: 1.140–7.798, p = 0.026), and hearing loss (OR: 3.219, 95% CI : 1.260–8.170, p = 0.014). Prolonged hospital stays emerged as the sole factor significantly associated with pressure ulcers (OR: 1.071, 95% CI: 1.033–1.109). Furthermore, an intricate bidirectional relationship was evident between delirium and pressure ulcers (OR: 7.158, 95% CI: 2.962–17.300, p < 0.01). Conclusion In conjunction with its consequent interventions, geriatric evaluation assumes a pivotal role in ameliorating adverse outcomes stemming from hospitalization among older adults afflicted with pulmonary ailments. This role gains particular salience among subpopulations characterized by heightened susceptibility, such as individuals coping with hearing loss and severe disability.","PeriodicalId":32862,"journal":{"name":"Aging Medicine","volume":"12 9","pages":"0"},"PeriodicalIF":2.2000,"publicationDate":"2023-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Geriatric care‐related outcomes in patients 75 years and older admitted to a pulmonary disease center and predictors for hospital‐related complications\",\"authors\":\"Daniela Josefina Cataneo‐Piña, Celia Gabriela Hernández‐Favela, Lidia Aurora Mondragón‐Posadas, Citlalic Torres Nuñez\",\"doi\":\"10.1002/agm2.12271\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Abstract Objective The primary aim of this study was to evaluate the influence of targeted interventions, administered through comprehensive geriatric assessments on the incidence of hospitalization‐related complications among older adults diagnosed with pulmonary diseases. Methods A retrospective analysis of medical records encompassed individuals aged 75 years and older who were admitted to a lung center during the period spanning from March to June 2023. These admissions occurred in a context where standardized geriatric management protocols were systematically implemented. This study's scope extended to assessing the prevalence of hospital‐related complications, encompassing delirium and pressure ulcers. A rigorous multivariate logistic regression analysis was conducted to discern and characterize associated factors. Results The integration of comprehensive geriatric assessment yielded a substantial reduction in in‐hospital complications among the cohort of 118 patients (mean age : 82.1 ± 5.6 years, 44.5% women). The incidence of delirium decreased from 53.3% to 21.8% [odds ratio (OR): 0.246, 95% confidence interval (CI): 0.134–0.450, p < 0.001], whereas the presence of pressure ulcers decreased from 43.9% to 25% (OR: 0.395, 95% CI: 0.217–0.715, p < 0.001). The multivariate analysis uncovered independent associations between delirium and variables including community‐acquired pneumonia (OR: 4.417, 95% CI : 1.574–12.395, p = 0.005), severe disability (OR: 2.981, 95% CI: 1.140–7.798, p = 0.026), and hearing loss (OR: 3.219, 95% CI : 1.260–8.170, p = 0.014). Prolonged hospital stays emerged as the sole factor significantly associated with pressure ulcers (OR: 1.071, 95% CI: 1.033–1.109). Furthermore, an intricate bidirectional relationship was evident between delirium and pressure ulcers (OR: 7.158, 95% CI: 2.962–17.300, p < 0.01). Conclusion In conjunction with its consequent interventions, geriatric evaluation assumes a pivotal role in ameliorating adverse outcomes stemming from hospitalization among older adults afflicted with pulmonary ailments. This role gains particular salience among subpopulations characterized by heightened susceptibility, such as individuals coping with hearing loss and severe disability.\",\"PeriodicalId\":32862,\"journal\":{\"name\":\"Aging Medicine\",\"volume\":\"12 9\",\"pages\":\"0\"},\"PeriodicalIF\":2.2000,\"publicationDate\":\"2023-11-12\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Aging Medicine\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1002/agm2.12271\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"GERIATRICS & GERONTOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Aging Medicine","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1002/agm2.12271","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"GERIATRICS & GERONTOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
摘要目的本研究的主要目的是通过综合老年病学评估评估针对性干预措施对诊断为肺部疾病的老年人住院相关并发症发生率的影响。方法回顾性分析2023年3月至6月期间在肺科中心住院的75岁及以上患者的医疗记录。这些入院是在标准化老年管理协议系统实施的背景下发生的。本研究的范围扩展到评估医院相关并发症的患病率,包括谵妄和压疮。进行了严格的多变量逻辑回归分析,以辨别和表征相关因素。结果综合老年病学评估使118例患者(平均年龄:82.1±5.6岁,44.5%为女性)的院内并发症显著减少。谵妄的发生率从53.3%下降到21.8%[优势比(OR): 0.246, 95%可信区间(CI): 0.134-0.450, p <0.001],而压疮的发生率从43.9%降至25% (OR: 0.395, 95% CI: 0.217-0.715, p <0.001)。多变量分析揭示了谵妄与社区获得性肺炎(OR: 4.417, 95% CI: 1.574-12.395, p = 0.005)、严重残疾(OR: 2.981, 95% CI: 1.140-7.798, p = 0.026)和听力损失(OR: 3.219, 95% CI: 1.260-8.170, p = 0.014)等变量之间的独立关联。延长住院时间是与压疮显著相关的唯一因素(OR: 1.071, 95% CI: 1.033-1.109)。此外,谵妄和压疮之间明显存在复杂的双向关系(OR: 7.158, 95% CI: 2.962-17.300, p <0.01)。结论:结合随后的干预措施,老年评估在改善肺部疾病老年人住院治疗的不良后果方面起着关键作用。这一作用在易感性较高的亚群体中尤其突出,例如听力损失和严重残疾的个体。
Geriatric care‐related outcomes in patients 75 years and older admitted to a pulmonary disease center and predictors for hospital‐related complications
Abstract Objective The primary aim of this study was to evaluate the influence of targeted interventions, administered through comprehensive geriatric assessments on the incidence of hospitalization‐related complications among older adults diagnosed with pulmonary diseases. Methods A retrospective analysis of medical records encompassed individuals aged 75 years and older who were admitted to a lung center during the period spanning from March to June 2023. These admissions occurred in a context where standardized geriatric management protocols were systematically implemented. This study's scope extended to assessing the prevalence of hospital‐related complications, encompassing delirium and pressure ulcers. A rigorous multivariate logistic regression analysis was conducted to discern and characterize associated factors. Results The integration of comprehensive geriatric assessment yielded a substantial reduction in in‐hospital complications among the cohort of 118 patients (mean age : 82.1 ± 5.6 years, 44.5% women). The incidence of delirium decreased from 53.3% to 21.8% [odds ratio (OR): 0.246, 95% confidence interval (CI): 0.134–0.450, p < 0.001], whereas the presence of pressure ulcers decreased from 43.9% to 25% (OR: 0.395, 95% CI: 0.217–0.715, p < 0.001). The multivariate analysis uncovered independent associations between delirium and variables including community‐acquired pneumonia (OR: 4.417, 95% CI : 1.574–12.395, p = 0.005), severe disability (OR: 2.981, 95% CI: 1.140–7.798, p = 0.026), and hearing loss (OR: 3.219, 95% CI : 1.260–8.170, p = 0.014). Prolonged hospital stays emerged as the sole factor significantly associated with pressure ulcers (OR: 1.071, 95% CI: 1.033–1.109). Furthermore, an intricate bidirectional relationship was evident between delirium and pressure ulcers (OR: 7.158, 95% CI: 2.962–17.300, p < 0.01). Conclusion In conjunction with its consequent interventions, geriatric evaluation assumes a pivotal role in ameliorating adverse outcomes stemming from hospitalization among older adults afflicted with pulmonary ailments. This role gains particular salience among subpopulations characterized by heightened susceptibility, such as individuals coping with hearing loss and severe disability.