老年住院患者慢性疾病和老年综合征患病情况分析

Clinical investigation and analysis of chronic diseases and geriatric syndromes in elderly inpatients

目的分析老年住院患者的慢性疾病和老年综合征的患病情况。方法回顾性病例对照研究,收集2018年6-12月北京市航天中心医院老年医学二科收治的老年患者227例进行老年综合评估。按年龄分为80~95岁组137例和65~79岁组90例,比较两组患者慢性疾病患病率和老年综合征分布情况。结果227例患者慢性疾病排前5位为高血压155例(68.3%)、脑血管病108例(47.8%)、冠心病103例(45.4%)、骨关节病89例(39.2%)、2型糖尿病79例(34.8%)。老年住院患者慢性疾病和老年综合征的数量呈随增龄而增加。80~95岁组患者与65~79岁组患者比较,营养不良及风险、认知功能受损、视力受损、听力下降、尿失禁、便秘发病率高;功能方面基本日常生活活动能力(ADL)和工具性日常生活活动能力(IADL)下降、衰弱更严重(均P<0.05);多重用药、焦虑抑郁状态、睡眠障碍、慢性疼痛、跌倒,差异无统计学意义(均P>0.05)。慢性疾病数量与老年综合征的数量呈正相关(r=0.339,P<0.01)。结论老年住院患者随增龄,慢性疾病患病数量增多,老年综合征更加突出,功能衰退明显,应对老年患者做好老年综合评估,及时发现并干预这些老年问题。

Objective To investigate and analyze the chronic diseases and geriatric syndromes in elderly inpatients. Methods A total of 227 elderly patients undergoing the comprehensive geriatric assessment admitted into geriatric ward of our hospital from June to December in 2018 were retrospectively analyzed in this case-control study.The patients were divided into two groups aged 80-90 years(n=137)and 65-79 years(n=90). The prevalence of chronic diseases and distribution of geriatric syndromes were compared between the two groups. Results Among 227 patients, the top five chronic diseases were primary hypertension(155 cases, 68.3%), cerebrovascular diseases(108 cases, 47.8%), coronary heart disease(103 cases, 45.4%), osteoarthrosis(9 cases, 39.2%)and type 2 diabetes mellitus(79 cases, 34.8%). The prevalence of chronic diseases and geriatric syndromes showed an increased tendency along with ageing in elderly patients.The incidence rate of malnutrition, nutritional risk, cognitive disorders, poor vision, hearing loss, fecal and urinary incontinence and constipation were higher in the group aged 80-90 years than in the group aged 65-79 years(P<0.05). The decreases of activities of daily life and instrumental activities of daily life, and fragile were more severe in the group aged 80-90 years than in the group aged 65-79 years(P>0.05). No significant difference was found between the two groups in the incidences of multidrug use, mood disorder, sleep disorder, chronic pain and falls.The prevalence of chronic diseases was positively correlated with the prevalence of geriatric syndromes(r=0.339, P<0.01). Conclusions Along with ageing in elderly inpatients, the number of chronic diseases is increased, geriatric syndromes are more obvious, and the function significantly declines in elderly inpatients.Elderly patients should receive the comprehensive geriatric assessment, in order to timely identify and intervene these geriatric problems.