多学科医疗团队干预与老年急性期患者疾病恢复的相关性

Correlation between multidisciplinary medical intervention and recovery of the elderly patients with acute-phase diseases

目的评估多学科医疗团队参与管理老年急性期疾病的疗效及预后。方法纳入2017年9月至2018年3月宜宾市第二人民医院老年医学科合并老年综合征并进行多学科干预的122例老年急性期患者作为研究组,选取2016年10月至2017年4月同科室合并老年综合征的140例老年急性期患者作为对照组。比较2组患者住院期间用药情况、患者满意度、住院费用、出院时Barthel日常生活能力(ADL)评分、住院天数、全因死亡率等结局指标。采用SPSS 22. 0软件进行统计学分析。组间比较采用t检验或卡方检验。结果与对照组比较,研究组患者的用药数量[(8. 28±0. 18) vs (9. 33±0. 22),P <0. 05]及住院天数[(10. 42±0. 51) vs (11. 21±0. 73)d,P <0. 05]减少,患者满意度[(97. 56±4. 19) vs (91. 22±3. 71)分;P <0. 05]升高,患者住院费用[(7187. 55±17. 24) vs (7469. 34±22. 18) RMB$,P <0. 05]下降,Barthel ADL评分[(83. 36±4. 29) vs(63. 77±5. 36),P <0. 05]增高,全因死亡率下降(1. 64%vs 4. 63%,P <0. 05)。结论在老年病房中,多学科医疗团队的医疗干预可使老年患者出院时ADL更加独立,住院时间更短且花费更低,死亡率下降,同时患者及其家属的满意度均更高。

Objective To evaluate the efficacy of multidisciplinary medical intervention in the management of the elderly patients with acute-phase diseases and its effects on the prognosis. Methods Included as the study group were 122 elderly patients with acute-phase diseases and concomitant geriatric syndromes who received multidisciplinary medical intervention from September 2017 to March 2018, and as control group were 140 elderly patients with acute-phase diseases and concomitant geriatric syndromes treated from October 2016 to April 2017. The 2 groups were compared in the aspects of medications, patients′ satisfaction, hospitalization expenditure, Bathel activies of daily living （ADL） score on discharge, days of hospitalization, all-cause mortality and other outcome measures. SPSS statistics 22.0 was used for statistical analysis, and t test or Chi-square test for comparison between groups. Results Compared with control group, the applied drug species [（8.28±0.18） vs （9.33±0.22）, P 〈0.05 ]and hospitalization length [（ 10.42±0.51 ） vs （11.21±0.73）d, P 〈0.05 ] decreased, patients′ satisfaction [（97.56±4.19） vs （91.22±3.71） score, P 〈0.05 ] increased, hospitalization expenditure [（7187.55±17.24） vs （7469.34±22.18） RMB￥, P 〈0.05] decreased, the Barthel ADL score [（83.36±4.29） vs （63.77±5.36）, P 〈0.05] increased and all-cause mortality （1.64% vs 4.63%, P 〈0.05 ） decreased. Conclusion Multidisciplinary medical intervention in the elderly contributes to greater patient′s independence, shorter hospitalization and lower expenditure, the decreased mortality, and greater satisfaction of patients and their families.