利用 Gugging 吞咽筛查对老年患者实施吸入预防计划的效果

IF 3.5 3区 医学 Q2 GERIATRICS & GERONTOLOGY
Clinical Interventions in Aging Pub Date : 2024-08-22 eCollection Date: 2024-01-01 DOI:10.2147/CIA.S474569
Ji Eun Song, Eunjeong Ji, Nak-Hyun Kim, Jung Hun Ohn, Yejee Lim, Jongchan Lee, Hye Won Kim, Sun-Wook Kim, Jiwon Ryu, Hee-Sun Park, Eun Sun Kim
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引用次数: 0

摘要

目的:老年患者住院时发生吸入性肺炎和死亡的风险较高。我们旨在评估利用 Gugging 吞咽筛查(GUSS)对老年患者进行吸入预防质量改进(QI)计划的效果:这项回顾性队列研究在韩国一家三甲医院的急诊科进行。研究采用一对一倾向匹配法,96 名患者接受了 QI 项目,96 名患者未接受 QI 项目。所有患者的年龄都在 65 岁或以上,都有吸入的风险因素,包括神经和非神经疾病、神经肌肉疾病、气道防御功能受损以及食道或胃肠疾病导致的吞咽困难。主要结果包括住院期间禁食时间的长短、入院前和出院时营养状况的变化、院内死亡率以及 90 天内因肺炎再次入院的情况:结果:GUSS 组和非 GUSS 组患者的禁食时间、入院后出院时体重和白蛋白水平的变化以及住院时间没有显著差异。然而,接受 GUSS 的患者在 90 天内再次入院的风险明显低于未接受 GUSS 的患者(危险比为 0.085;95% 置信区间为 0.025-0.290;P = 0.001):结论:GUSS吸入预防计划可有效预防老年急症患者在90天内因肺炎再次入院。这意味着,在老年急症患者中采用高效的吸入预防方法可以提高患者的治疗效果,并有可能降低与再入院相关的医疗成本,从而发挥关键作用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Efficacy of an Aspiration Prevention Program That Utilizes the Gugging Swallowing Screen in Older Patients.

Purpose: Older patients have a higher risk of aspiration pneumonia and mortality if they are hospitalized. We aimed to assess the effectiveness of an aspiration prevention quality improvement (QI) program that utilizes the Gugging Swallowing Screen (GUSS) in older patients.

Patients and methods: This retrospective cohort study was conducted in an acute medical care unit of a tertiary hospital in South Korea. The study used one-to-one propensity matching and included 96 patients who received the QI program and 96 who did not. All patients were aged 65 years or older and had risk factors for aspiration, including neurological and non-neurological disorders, neuromuscular disorders, impaired airway defenses, and dysphagia due to esophageal or gastrointestinal disorders. The primary outcomes included the duration of the fasting period during hospitalization, changes in nutritional status before admission and at discharge, in-hospital mortality, and readmission due to pneumonia within 90 days.

Results: Fasting period, changes in weight and albumin levels upon discharge after hospitalization, and length of stay did not differ significantly between patients in the GUSS and non-GUSS groups. However, the risk of readmission within 90 days was significantly lower in patients who underwent the GUSS than in those who did not (hazard ratio, 0.085; 95% confidence interval, 0.025-0.290; p = 0.001).

Conclusion: The GUSS aspiration prevention program effectively prevented readmission due to pneumonia within 90 days in older patients with acute illnesses. This implies that the adoption of efficient aspiration prevention methods in older patients with acute illnesses could play a pivotal role by enhancing patient outcomes and potentially mitigating the healthcare costs linked to readmissions.

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来源期刊
Clinical Interventions in Aging
Clinical Interventions in Aging GERIATRICS & GERONTOLOGY-
CiteScore
6.80
自引率
2.80%
发文量
193
审稿时长
6-12 weeks
期刊介绍: Clinical Interventions in Aging, is an online, peer reviewed, open access journal focusing on concise rapid reporting of original research and reviews in aging. Special attention will be given to papers reporting on actual or potential clinical applications leading to improved prevention or treatment of disease or a greater understanding of pathological processes that result from maladaptive changes in the body associated with aging. This journal is directed at a wide array of scientists, engineers, pharmacists, pharmacologists and clinical specialists wishing to maintain an up to date knowledge of this exciting and emerging field.
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