Oud, F.M.M. (2013) Voorspellende waarde van de “Veiligheidsmanagementsysteem screeningsbundel kwetsbare ouderen’’ voor functieverlies. thesis, Medicine.
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Abstract
Background: Due to the aging of the population the number of elderly admitted to hospitals will continue to increase over the next decades. 30-60% of elderly admitted to the hospital experience functional decline. A national government induced instrument (VeiligheidsManagement Systeem (VMS)) for screening of vulnerable elderly is used in 93 Dutch hospitals to prevent functional decline. By identifying elderly (aged >70) at risk for delirium, falls, malnutrition and functional impairment, adequate preventive measures can be taken. The VMS screening method however has not been validated yet. Objectives: The first objective of this study is to determine the predictive value of the VMS screening for functional decline 24 months after hospitalisation. The second objective is to determine the predictive value of the screening for falling and delirium. Design and setting: Retrospective observational study in patients of 70 years of age and above admitted from 28 March 2011 to 10 June 2011 to the Deventer Ziekenhuis in the Netherlands. Method: 24 months after hospitalisation data ware collected about functional decline, mortality and rehospitalisation and the incidence of falls and delirium. Results: 687 patients were included, the median age was 78,7 (range: 70,0-79,1) and 348 (50,7%) were male. After 3 months 84 (12,2%) patients had died and after 24 months 155 (33%) patients. 287 (40,5%) patients experienced functional decline. Independent predictors for functional decline were delirium risk (Odds Ratio (OR): 2,11; 95%-Confidence Interval (CI) 1,44-3,10), functional impairment (OR: 1,93; 95%-CI 1,28-2,90), admission to a non-surgical ward (OR: 0,39; 95%-CI 0,28-0,56) and older age (OR: 1,06; 95%-CI 1,03-1,09). The sensitivity of the screening for delirium risk is 83% and the specificity is 62%. The sensitivity of the screening for fall risk is 63% and the specificity is 65%. Conclusions: The VMS screening method vulnerable elderly has predictive value for functional decline. The VMS screening for delirium is a reasonable instrument to identify elderly at risk for delirium, the screening for fall risk however is moderate.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Schuurman, Drs. G. |
| Supervisor name: | Munster, Dr. B.C. van and Gelre Ziekenhuis, Apeldoorn |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 11:06 |
| Last Modified: | 25 Jun 2020 11:06 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/2600 |
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