老年综合评估在老年社区获得性肺炎中的应用价值

Application value of geriatric comprehensive assessment in elderly patients with community acquired pneumonia

目的探讨老年综合评估及干预对老年社区获得性肺炎预后的影响。方法本研究为队列研究。采用随机抽样法,选取2019年10月至2021年11月山西白求恩医院综合医疗科住院的老年社区获得性肺炎患者93例,随机分为常规治疗组(n=45)和观察组(n=48)。观察组在常规治疗基础上,基于老年综合评估进行综合干预。所有受试者在入院1~2天内及3个月后进行老年综合评估。观察老年综合评估对老年社区获得性肺炎患者疾病疗效、再发肺炎、重症肺炎、呼吸衰竭、生活质量等方面的影响。结果观察组的住院天数、再发肺炎、重症肺炎及合并症显著低于常规治疗组(t=4.98、χ^(2)=4.77、χ^(2)=4.48、χ^(2)=4.06,均P<0.05),而治疗总有效率显著高于常规治疗组(χ^(2)=1.21,P=0.012)。同时观察组在日常生活能力评分、跌倒评分、认知功能评分、焦虑评分、抑郁评分、营养评分等老年综合征评估方面较常规治疗组明显改善(t值分别为2.58、5.16、3.72、3.24、6.13、3.33,均P<0.05)。结论尽早启用老年综合评估并进行干预,可改善老年社区获得性肺炎患者的生活质量及预后。

Objective To explore the effect of comprehensive geriatric assessment(CGA)and reasonable interventions on the prognosis of elderly patients with community acquired pneumonia(CAP).Methods It was a cohort study.A total of 93 elderly patients with CAP admitted to the General Medical Department of Shanxi Bethune Hospital from October 2019 to November 2021 were selected by random sampling method.They were randomly assigned into observation group(n=48)and conventional treatment group(n=45).Conventional interventions were applied to patients in both groups,and those in the observation group were additionally given CGA and interventions.CGA was performed on 12 days and 3 months after admission.The influence of CGA on the therapeutic efficacy,recurrence of pneumonia,severe pneumonia,respiratory failure,and quality of life was observed.Results The length of hospital stay,the incidence of recurrence of pneumonia,severe pneumonia,and complications in the observation group were significantly lower than those of conventional treatment group(t=4.98,χ^(2)=4.77,χ^(2)=4.48,χ^(2)=4.06,all P<0.05).The total effective rate was significantly higher in the observation group than that of conventional treatment group(χ^(2)=1.21,P=0.012).At the same time,compared to the conventional treatment group,the observation group showed significant improvement in elderly syndrome assessments such as daily living ability score,fall score,cognitive function score,anxiety score,depression score,and nutrition score(t values were2.58,5.16,3.72,3.24,6.13,and 3.33,respectively,all P<0.05).Conclusions CGA and certain interventions applied to elderly CAP patients as early as possible would improve the quality of life and prognosis.