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|本期目录/Table of Contents|

术前综合评估对老年冠心病患者冠状动脉介入治疗后中短期再入院率和门诊率的影响

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2018年第1期
页码:
21-025
栏目:
老年心血管病研究
出版日期:
2017-10-10

文章信息/Info

Title:
Effect of preoperative comprehensive geriatric assessment (CGA) on the post-discharge readmission and outpatient visits follow-up 3 and 6 months in elderly patients with coronary artery disease after percutaneous coronary intervention
作者:
王笑梅1; 王 端2; 刘凌琳1; 李学军1
（1.陆军军医大学附属西南医院老年病科，重庆 400038；2.重庆医科大学附属第三医院心脏内科，重庆 400038）
Author(s):
WANG Xiao-mei1;  WANG Duan2;  LIU Ling-lin1;  LI Xue-jun1
(1.Department of Geriatrics, Southwest Hospital, Army Medical University, Chongqing 400038, China; 2.Department of Cardiology, Third Affiliated Hospital, Chongqing Medical University, Chongqing 400038, China)
关键词:
术前综合评估; 冠状动脉介入治疗; 老年人; 再入院率; 门诊就诊率
Keywords:
preoperative comprehensive geriatric assessment;  percutaneous coronary intervention;  elderly;  readmission;  outpatient visits
分类号:
R541.4
DOI:
-
文献标识码:
A
摘要:
目的 了解术前综合评估能否降低老年冠心病患者冠脉介入治疗术后3个月及6个月内非计划再入院率及门诊就诊率。方法 冠心病住院的老年患者100名，患者随机进入综合评估（CGA）组和常规治疗组。综合评估组患者根据CGA结果制定患者围手术期及出院后治疗方案，常规治疗组患者按照常规制定方案，每组又按是否接受了冠脉介入手术治疗，分为手术亚组和未手术亚组。所有患者在出院后3、6月进行电话随访，随访内容包括患者是否在出院后3、6个月因为各种原因再次入院治疗，是否因为各种不适门诊就诊。结果 无论是否接受CGA和冠脉介入手术，各组患者出院后3、6月再入院率均无明显差异。与常规治疗组患者相比，综合评估组患者出院后3个月门诊率无明显差异，出院后6个月门诊率显著降低（36% vs. 56%，P<0.05）。与常规治疗组的手术亚组患者相比，综合评估组的手术亚组老年患者出院后3个月（33% vs. 75%，P<0.05）、6个月（53% vs. 100%，P<0.01）的门诊率均显著降低。结论 术前CGA可以显著降低接受了冠脉介入手术的老年冠心病患者出院后中短期门诊率。
Abstract:
AIM To investigate whether preoperative evaluation reduces the rate of unplanned hospitalization and outpatient visits within 3 and 6 months after coronary intervention in elderly patients with coronary heart disease. METHODS 100 elderly patients undergoing coronary heart disease were randomly assigned to the comprehensive assessment (CGA) group (comprehensive assessment group) and a routine treatment group. The patients in the comprehensive evaluation group developed the patients’ perioperative and post-discharge treatment regimen, according to comprehensive evaluation results. In the conventional treatment group, the patients were treated according to the conventional procedure. Each group was divided into surgical and non-surgical subgroups, according to the interventional treatment of coronary intervention. All patients were followed up by telephone at 3 and 6 months after discharge. The follow-up included whether the patient was hospitalized for unexplained hospital admissions and reasons. RESULTS There was no significant difference in admission rate between the two groups at 3 and 6 months after discharge, regardless of whether CGA and coronary intervention were received. There was no significant difference in the outpatient rate between the two groups at the end of 3 months after discharge, and the outpatient rate was significantly lower (36% vs. 56%, P<0.05) at 6 months after discharge when compared with the conventional treatment group. Compared with those in the subgroup of patients undergoing surgery in the conventional treatment group, patients in the comprehensive assessment group undergoing surgery were significantly lower (3 months, 33% versus 0.75%, P<0.05; 6 months, 53% vs. 100%, P<0.01). CONCLUSION Preoperative comprehensive assessment significantly reduces the number of patients admitted to the hospital for coronary heart disease after coronary intervention and short-term re-admission rate and outpatient attendance.

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备注/Memo

备注/Memo:
收稿日期：2017-08-22.基金项目：西南医院临床课题资助(SWH2013LC06) 通讯作者：李学军，副主任医师，主要从事老年慢性病及健康管理研究 Email:lixuejun@126.com 作者简介：王笑梅，副教授，博士 Email：wxm091@163.com
更新日期/Last Update: 1900-01-01