【摘要】 目的 评价老年综合评估（Comprehensive Geriatric Assessment,CGA）在老年住院患者多重用药管理中的作用。方法 以2019年1月1日-2019年6月31日在我科住院患者（年龄≥65岁）为研究对象，实施CGA，根据CGA结果制定综合干预措施，并在干预方案实施第1月后随访研究对象。分析其在多重用药管理中的作用。结果 97.4%老年患者入院时有长期用药史，多重用药检出率为50.5%；干预后，多重用药状况明显改善（31.3%），用药种类减少，差异均有统计学意义（P <0.001）。多重用药与共病相关（χ~2=28.781,P <0.001），但与常见老年综合征不相关。Logistics分析结果提示：随着Charlson共病指数增高，多重用药风险增加（P=0.006,OR=1.400,95%CI为1.104-1.776）；独居者多重用药风险增加（P=0.005,OR=2.3700,95%CI为1.303-4.310）。结论 老年住院患者多重用药检出率高，共病、独居是多重用药危险因素；CGA及干预可及时发现、改善多重用药，减少医疗资源的浪费，减轻患者家庭和社会负担。更多还原

【Abstract】 Objective To evaluate the effect of comprehensive geriatric assessment(CGA)in the management of polypharmacy in elderly inpatients. Methods The inpatients(age≥65 years old)in our department from January 1, 2019 to June 31, 2019 were selected as the research subjects. The comprehensive intervention measures were formulated according to the results of CGA. All subjects were followed up after the implementation of the intervention scheme for 1 month. Then we analyzed the role of CGA in the management of polypharmacy. Results 97.4% of the elderly patients had a long-term medication history, and the detection rate of polyphamacy was50.5%. After the intervention, the situation of polyphamacy was significantly improved(31.3%, P < 0.001), and the types of drug use were significantly reduced, with statistical significance(P < 0.001). Polypharmacy was associated with multimorbidity （χ2= 28.781, P <0.001）, but not with common geriatric syndrome. Logistic analysis showed that with the increase of Charlson multimorbidity index, the risk of polypharmacy was increased(P = 0.006, OR = 1.400, 95% CI:1.104-1.776), and the risk of polypharmacy was increased in people living alone(P = 0.005, OR = 2.3700, 95% CI:1.303-4.310). Conclusion The detection rate of polypharmacy in elderly inpatients is high, multiomorbidity and living alone are the risk factors of it. CGA and intervention can timely detect and improve polypharmacy. It can reduce the waste of medical resources and the burden of patients’ families and society.更多还原