住院患者老年综合评估规范及初步效果分析

目的：探讨在老年住院患者中进行老年综合评估（CGA）对于老年人全面综合管理的作用。方法制定标准的CGA流程，采用标准流程对北京协和医院老年病房2013年9月至2014年9月连续入院的≥65岁患者进行CGA，分析其筛查老年综合征的效果。结果标准化的评估流程便于临床使用，接受评估的179例患者中，年龄（72.5±8.1）岁。通过CGA发现，视力异常患者占62.0%，睡眠障碍41.3%，听力异常40.8%，慢性疼痛34.6%，跌倒25.7%，多重用药23.5%，便秘21.8%，抑郁焦虑18.4%，尿失禁16.2%，谵妄10.6%。以不同主诉入院的15例患者最终诊断为老年综合征,占8.4%。结论老年综合征在老年患者中普遍存在，运用标准化的CGA方法可以进行有效筛查，有利于老年患者的全人管理。

Standardization and preliminary effect of comprehensive geriatrics assessment for elderly inpatients

Objective To investigate the role of comprehensive geriatric assessment (CGA) in comprehensive management for the elderly inpatients. Methods A standard CGA process was built and then employed to assess the elderly inpatients (over 65 years old) within 48 h after consecutively admitted in the Geriatric Ward of our hospital from September 2013 to September 2014. The effect of CGA was evaluated. Results Our standard CGA process was very convenient in clinical practice. There were 179 patients over 65 years were enrolled in this study, with an age of (72.5±8.1) years. CGA showed the following geriatrics syndrome: 62.0% with poor vision, 41.3% with sleep disorder, 40.8% with hearing loss, 34.6% with pain, 25.7% having falls, 23.5% having polypharmacy, 21.8% with constipation, 18.4% with mood disorder, 16.2% with incontinence, and 10.6% with cognitive impairment. There were 15 elderly patients (8.4%) who were admitted because of different complaints but finally discharged with the first diagnosis of geriatric syndrome. Conclusion Geriatric syndrome is very common in the elderly inpatients. Standard CGA can effectively screen those with geriatric syndrome, and helpful to the holistic management for them.