在老年住院患者中,与急性伤害性落相关的因素:多中心描述性研究
Joint Commission journal on quality and patient safety
|July 24, 2023
概括
在医院经历严重跌倒的老年人更有可能患有痴呆症和较高的抗胆固醇认知负担 (ACB) 评分. 特定的药物,包括抗胰岛素药物和抗精神病药物,与这些跌倒有关,为质量改善工作提供了信息.
科学领域:
- 老年医学 老年医学
- 患者安全 患者安全
- 医疗保健服务研究 医疗服务研究
背景情况:
- 医院获得的疾病 (CMS-HAC) 将医疗保险支付与医疗保健质量联系起来.
- 住院患者的跌倒造成严重后果是需要改进的重要领域.
- 影响老年人的认知功能的药物是导致跌倒的潜在原因.
研究的目的:
- 调查常规处方药类对CMS-HAC跌倒和创伤的影响.
- 分析来自美国医院 (2019-2021) 的大型住院患者数据库.
主要方法:
- 从835家医院 (2019-2021) 对65岁以上的CMS-HAC跌倒和创伤患者的数据分析.
- 利用后勤回归和逐步波桑回归来识别相关变量.
- 确定了在患有摔倒的患者中最常被处方的20种药物类别.
主要成果:
- 在超过1100万次遭遇中,5978次符合CMS-HAC的严重落定义.
- 老年患者 (>79岁),有先前跌倒,痴呆症和较高抗胆固醇认知负担 (ACB) 评分的患者更有可能经历严重跌倒.
- 第一代抗胰岛素,第二代抗胰岛素和非典型抗精神病药物与CMS-HAC跌倒有显著的关联.
结论:
- 符合CMS-HAC定义的跌倒与跌倒史,痴呆症和更高的ACB分数有关.
- 结果可以指导质量改进计划,以减少医疗机构的伤害性跌倒.
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