老年综合评估及多学科团队服务在老年共病干预中的应用

目的 探讨住院老年患者通过老年综合评估(CGA)及多学科团队服务(GITS)进行多维度诊疗，为老年患者提供科学、合理的个性化诊疗模式，有效改善共病诊疗效果及生活质量。方法 选取年龄≥60岁的老年科共病患者，分为观察组和对照组。使用自主开发的“老年综合评估软件V2.0”对210例老年患者入院7天内进行老年综合评估，随后观察组根据评估结果给予共病、老年综合征、心理、认知及生活方式等全面综合干预，对照组仅给予共病干预。干预3个月后行第2次老年综合评估，比较观察组与对照组共病及生活质量改善情况。结果 (1)观察组比对照组血压、血糖控制效果更好(P<0.05),观察组比对照组慢性心衰急性加重、慢性阻塞性肺疾病急性加重发生人数减少(P<0.05)。(2)老年综合征及生活质量：观察组比对照组Barthel指数得分及MMSE得分显著提高(P<0.05),观察组比对照组营养、抑郁、焦虑、跌倒、衰弱均有显著改善(P<0.05),因促眠药物的应用观察组与对照组睡眠障碍均有改善，改善程度无显著差异(P>0.05)。结论 老年患者住院期间进行老年综合评估并结合多学科团队服务，可以及...

Application of comprehensive geriatric assessment and geriatric interdisciplinary teams service in elderly comorbidity intervention

Objective To explore the multidimensional diagnosis and treatment of hospitalized elderly patients through comprehensive geriatric assessment(CGA)and geriatric interdisciplinary teams service(GITS),provide scientific and reasonable personalized diagnosis and treatment mode for elderly patients,and effectively improve the effect of comorbidity diagnosis and treatment and quality of life.Methods Elderly patients≥60 years old were selected and divided into observation group and control group.The self-developed'CGA software V2.0'was used to evaluate 210 elderly patients within 7 days of admission.According to the evaluation results,the observation group was given comprehensive intervention such as comorbidity,geriatric syndrome,psychology,cognition and lifestyle.The control group was only given comorbidity intervention.After 3 months of intervention,the second CGA of the elderly was conducted to compare the comorbidity and quality of life improvement between the observation group and the control group.Results①The blood pressure and blood glucose in the observation group were better controlled than those in the control group(P<0.05).The number of patients with acute exacerbation of chronic heart failure and chronic obstructive pulmonary disease in the observation group was lower than that in the control group(P<0.05).②Elderly syndrome and quality of life:Barthel index score and MMSE score of the observation group were significantly higher than those of the control group(P<0.05).Nutrition,depression,anxiety,fall and frailty were significantly improved in the observation group than in the control group(P<0.05).The sleep disorder of the observation group and the control group was improved,but there was no significant difference in the degree of improvement(P>0.05).Conclusion Elderly hospitalized patients were given CGA and GITS,early detection of elderly syndrome and elderly problems,early comprehensive intervention for comorbidity,elderly syndrome and other issues,significantly improve the efficacy of comorbidity management and quality of life.