■原著
当院高度救命救急センターにおける高齢者医療の現状
恩田 秀賢, 鈴木 剛, 松本 学, 金 史英, 辻井 厚子, 新井 正徳, 宮内 雅人, 布施 明, 川井 真, 横田 裕行
日本医科大学付属病院高度救命救急センター
Treatment State of Elderly Patients at Our Emergency and Critical Care Medical Center
Hidetaka Onda, Go Suzuki, Gaku Matsumoto, Shiei Kin, Atsuko Tsujii, Masatoku Arai, Masato Miyauchi, Akira Fuse, Makoto Kawai and Hiroyuki Yokota
Department of Emergency and Critical Care Medicine, Nippon Medical School
Introduction: Backed by elderly person society, the number of patients of an elderly person targeted for the emergency and critical care medical center. In late years a tendency to increase has the ratio of elderly person among the hospitalization drastically in our facility. Because the elderly person has various underlying diseases, prolongation of the length of hospital stay is a problem.
Purpose: Examined an outcome and the hospitalization of an elderly person transported to our facility and the present conditions and problems of the elderly person medical care in the emergency and critical care medical center.
Material and Method: From January 1st, 2004 to December 31th, 2010, 14,290 patients transported to our facility. The tendency of 5,403 over 65 years old patients except the cardiopulmonary arrest case, an outcome and hospitalization compared it with 7,143 under 64 years cases. Investigated a characteristic and the hospitalization of the disease and an outcome.
Result: A tendency to increase in 49.1% year by year was seen in the ratio that the elderly person occupied among all inpatients in 2010 whereas 2004 was 39.9%. The increase of the elderly person 80 years or older became 21.1% of 2010 remarkably for 13.4% of 2004. On the other hand, home discharge of elderly people was lower than that for non-elderly people (23% vs. 51.3%, P<0.0001). The number of the specialists in change of the elderly person is before and after 300 cases every year. For the mean hospitalization, no recognition of the difference in non-elderly people with an elderly person (12.8±23.1 vs. 12.7±18.6, p=0.87).
Conclusion: The ratio of elderly person for the hospitalization was a course of the increase, and the condition of a patient peculiar to an elderly person was frequent. A difference was in state that there was not it in non-elderly people with an elderly person by the cooperation with a smooth backward hospital at present for the mean hospitalization. It is necessary to perform the pathologic understanding in the elderly person with the whole family. I think that there is the need to comprise in the future aging society while a local medical practitioner and specialist in institution, house call medicine and a hospital take the cooperation well.
日医大医会誌 2013; 9(2), 129-134
Key words
elderly person, emergency and critical care medical center, outcome and the hospitalization
Correspondence to
Hidetaka Onda, Department of Emergency and Critical Care Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan
E-mail：h-onda@nms.ac.jp
受付：2012年7月18日 受理：2012年12月22日 |
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