C Fernández Alonso1, M Fuentes Ferrer2, M I Jiménez Santana3, L Fernández Hernández3, M de la Cruz García3, J González Del Castillo1, J J González Armengol1, P Gil Gregorio4, E Calvo Manuel5, F J Martín-Sánchez6. 1. Servicio de Urgencias, Unidad de Corta Estancia, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital San Carlos, Madrid, España; Facultad de Medicina, Universidad Complutense de Madrid, Madrid, España. 2. Servicio de Medicina Preventiva, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital San Carlos, Facultad de Ciencias de la Salud, Universidad Alfonso X el Sabio, Madrid, España. 3. Servicio de Urgencias, Unidad de Corta Estancia, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital San Carlos, Madrid, España. 4. Facultad de Medicina, Universidad Complutense de Madrid, Madrid, España; Servicio de Geriatría, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital San Carlos, Madrid, España. 5. Facultad de Medicina, Universidad Complutense de Madrid, Madrid, España; Servicio de Medicina Interna, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital San Carlos, Madrid, España. 6. Servicio de Urgencias, Unidad de Corta Estancia, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital San Carlos, Madrid, España; Facultad de Medicina, Universidad Complutense de Madrid, Madrid, España. Electronic address: fjjms@hotmail.com.
Abstract
OBJECTIVE: To study the effect of a multidimensional intervention on the prognosis at 30 days for frail elderly patients discharged from a short-stay unit. MATERIAL AND METHOD: A quasiexperimental study was conducted with a historical control cohort. We included frail patients (Identification of Seniors at Risk score≥2) 75 years of age or older, discharged from an short-stay unit over 2 months in 2013 (control group) and in 2016 (intervention group). An intervention was conducted based on the activation of resources, based on the deficiencies detected after an abbreviated geriatric assessment, in conjunction with Primary Care. The main endpoint was the presence of an adverse result (death or readmission for any cause or severe functional impairment) at 30 days of discharge. RESULTS: We included 137 (62.8%) patients in the intervention group and 81 (37.2%) in the control group. Eighteen (13.1%) patients in the intervention group and 29 (35.8%) in the control group presented an adverse event at 30 days. A multivariate analysis showed that the implementation of a multidimensional intervention was a protective factor for presenting an adverse event at 30 days of discharge (adjusted RR 0.40; 95% CI 0.23-0.68; P=.001). CONCLUSIONS: The implementation of an individual care plan for frail elderly patients, based on the activation of resources according to the deficiencies detected after an abbreviated geriatric assessment and in conjunction with Primary Care, could improve the results at 30 days of discharge from an short-stay unit.
OBJECTIVE: To study the effect of a multidimensional intervention on the prognosis at 30 days for frail elderly patients discharged from a short-stay unit. MATERIAL AND METHOD: A quasiexperimental study was conducted with a historical control cohort. We included frail patients (Identification of Seniors at Risk score≥2) 75 years of age or older, discharged from an short-stay unit over 2 months in 2013 (control group) and in 2016 (intervention group). An intervention was conducted based on the activation of resources, based on the deficiencies detected after an abbreviated geriatric assessment, in conjunction with Primary Care. The main endpoint was the presence of an adverse result (death or readmission for any cause or severe functional impairment) at 30 days of discharge. RESULTS: We included 137 (62.8%) patients in the intervention group and 81 (37.2%) in the control group. Eighteen (13.1%) patients in the intervention group and 29 (35.8%) in the control group presented an adverse event at 30 days. A multivariate analysis showed that the implementation of a multidimensional intervention was a protective factor for presenting an adverse event at 30 days of discharge (adjusted RR 0.40; 95% CI 0.23-0.68; P=.001). CONCLUSIONS: The implementation of an individual care plan for frail elderly patients, based on the activation of resources according to the deficiencies detected after an abbreviated geriatric assessment and in conjunction with Primary Care, could improve the results at 30 days of discharge from an short-stay unit.
Authors: J González Del Castillo; F J Candel; J de la Fuente; F Gordo; F J Martín-Sánchez; R Menéndez; A Mujal; J Barberán Journal: Rev Esp Quimioter Date: 2018-10-04 Impact factor: 1.553