ABSTRACT
Objective:To evaluate dynamic changes of functional status in elderly emergency inpatients by using the interRAI Acute Care for Comprehensive Geriatric Assessment(interRAI AC-CGA), and to analyze whether assessment results are helpful for clinical decision-making.Methods:Elderly patients(aged 60 years and older)who were hospitalized in the Acute Care Unit of PLA General Hospital from October 2017 to March 2018 were included.Each patient received the interRAI AC-CGA instrument-based assessment at admission(day 1), on day 7 and day 28 after admission.Analysis of collected data was conducted using interRAI AC-CGA scales, geriatric syndrome screening and risk identification of adverse outcomes, in order to examine dynamic changes of functional status in patients at and after admission and to explore the relationship between functional status at admission and outcomes(at discharge).Results:Thirty-four patients were evaluated, including 26 males and 8 females, aged from 60 to 101 years, with a mean age of(84.2±10.1)years.Patients had a variety of functional abnormalities at admission and during hospitalization, in which the ability to perform activities of daily living(ADL)and instrumental activities of daily living(IADL)decreased significantly.Compared with evaluation results on day 1, the incidences of functional abnormalities on day 7 and day 28 declined, and there was improvement in transient depression, pain and falls( χ2=6.298, 6.027 and 7.766, P=0.043, 0.049 and 0.021). After evaluation on day 28, 16 patients were discharged and 18 remained hospitalized(including 2 deaths). The rate for most abnormality was lower in the discharge group than in the continued hospitalization group, and the rates for abnormal communication and falls were lower in the discharge group than in the continued hospitalization group( χ2=6.349 and 5.443, P=0.019 and 0.030). Age(≥85 years old)had no effect on discharge.There was no significant difference in hospital discharge rate between the advanced age group(≥85 years old)and the elderly group(60-84 years old)(40.0% or 8/20 vs.57.1% or 8/14, χ2=0.971, P=0.324). Conclusions:The interRAI AC-CGA instrument can systematically and dynamically estimate functional changes in elderly emergency inpatients.Functional status at admission is related to prognosis(performance at discharge)of patients.