Objective

Cardiovascular disease and frailty are common among the population aged 85+. We hypothesised these patients might benefit from geriatric co-management, as has been shown in other frail patient populations. However, there is limited evidence supporting geriatric co-management in older, hospitalised cardiology patients.

Methods

A retrospective cohort study was performed in a large teaching hospital in the Netherlands. We compared patients aged 85 and over admitted to the cardiology ward before (control group) and after the implementation of standard geriatric co-management (intervention group). Data on readmission, mortality, length of stay, number of consultations, delirium, and falls were analysed.

Results

The data of 1163 patients were analysed (n = 542 control, n = 621 intervention). In the intervention group, 251 patients did not receive the intervention because of logistic reasons or the treating physician’s decision. Baseline characteristics were comparable in the intervention and control groups. Patients in the intervention group had a shorter length of stay (−1 day, p = 0.01) and were more often discharged to a geriatric rehabilitation facility (odds ratio [OR] 1.97, 95% confidence interval [CI] 1.10–3.54, p = 0.02) compared with the control patients. Other outcomes were not significantly different between the groups.

Conclusions

After implementation of standard geriatric co-management for hospitalised cardiology patients aged 85 and over, the length of hospital stay shortened and the number of patients discharged to a geriatric rehabilitation facility increased. The adherence to geriatric team recommendations was high. Geriatric co-management would appear to optimise care for older hospitalised patients with cardiac disease.

中文翻译：

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老年共同管理对 85 岁及以上住院心脏病患者结局的影响

客观的

心血管疾病和虚弱在85岁以上的人群中很常见。我们假设这些患者可能会受益于老年共同管理，正如其他体弱患者群体所显示的那样。然而，支持对老年住院心脏病患者进行老年共同管理的证据有限。

方法

在荷兰一家大型教学医院进行了一项回顾性队列研究。我们比较了入住心脏病病房的 85 岁及以上患者在实施标准老年共同管理之前（对照组）和之后（干预组）。分析了再入院、死亡率、住院时间、就诊次数、谵妄和跌倒的数据。

结果

分析了 1163 名患者的数据（n  = 542 名对照患者，n  = 621 名干预患者）。在干预组中，有 251 名患者由于后勤原因或治疗医生的决定而没有接受干预。干预组和对照组的基线特征相当。干预组患者的住院时间较短（−1 天，p  = 0.01），并且更常出院到老年康复机构（比值比 [OR] 1.97，95% 置信区间 [CI] 1.10–3.54，p  = 0.02）与对照患者相比。各组之间的其他结果没有显着差异。

结论

对85岁及以上住院心脏病患者实施标准老年共同管理后，住院时间缩短，出院到老年康复机构的患者数量增加。对老年医学小组建议的遵守程度很高。老年科共同管理似乎可以优化老年心脏病住院患者的护理。