PDF(Pubmed)
Abstract：
The main objective of this study was to analyze the relationship between Geriatric Syndromes (GSs) and in-hospital mortality in adults aged 65 and older admitted to the Emergency Department (ED). The study included 202 Older Adults (OAs) who met the inclusion criteria. We conducted a Comprehensive Geriatric Assessment and collected clinical and demographic data. A univariate analysis was carried out for each of the GSs analyzed. Those variables with p < 0.05 were entered into a multiple logistic regression using the backward stepwise entry method to analyze the independent predictor variables. The average number of GSs per individual was 4.65 (±2.76). Frailty syndrome was the most prevalent (70.2% of patients). Our study found an association between mortality and some GSs, such as frailty (p = 0.042), risk of falls (p = 0.010), delirium, cognitive impairment, dependence, and risk of ulcers (p < 0.001). We found that cognitive impairment (adjusted OR, 6.88; 95% CI, 1.41-33.5; p = 0.017) and dependence (adjusted OR, 7.52; 95% CI, 1.95-29.98; p = 0.003) were independent predictors associated with mortality in our population. It is necessary to develop new care strategies in the ED that respond to the needs of aging societies, including the use of new technologies and personnel with experience in gerontology.
摘要：
这项研究的主要目的是分析急诊（ED）收治的65岁及以上成年人的老年综合征（GS）与住院死亡率之间的关系。该研究包括202名符合纳入标准的老年人（OAs）。我们进行了老年综合评估，并收集了临床和人口统计数据。对所分析的每个GS进行单变量分析。使用后向逐步进入方法将p<0.05的变量输入到多元逻辑回归中，以分析独立预测变量。每个个体的GSs平均数量为4.65(±2.76)。衰弱综合征是最普遍的（70.2%的患者）。我们的研究发现死亡率和一些GSs之间存在关联，例如脆弱(p=0.042)，跌倒风险(p=0.010)，谵妄,认知障碍，依赖，和溃疡的风险（p<0.001）。我们发现认知障碍(调整后的OR，6.88；95%CI，1.41-33.5；p=0.017）和依赖性（调整后的OR，7.52；95%CI，1.95-29.98；p=0.003）是与我们人群死亡率相关的独立预测因子。有必要在ED中开发新的护理策略，以应对老龄化社会的需求，包括使用具有老年学经验的新技术和人员。
