看護とケアのジャーナル

Vital signs, the magic key in preventing hospitalization and death of older adults living in nursing homes?

Abstract

Bonnez Yannic

B ackground:

Yearly, 10% of older adults living in nursing homes (NH) are hospitalized. The goal is to study the relation between (changing) vital parameters and negative health outcomes, and to develop an instrument able to detect early signs potentially giving rise to physical decline.

Method

Weekly assessing vital signs in 170 NH residents (≥65years) during 8 weeks. Medical records were consulted for the Katz-scores and registration of hospitalizations. This abstract was based on preliminary baseline data.

Results

10% of residents were hospitalized and 3% died during follow up (n=170). A significant positive correlation was found between heart ritme (HR) and hospitalization(r=0,152; p<0,05), HR and death (r=0,214;p<0,05) and a significant negative(moderate) correlation between saturation and death(r=-0,353;p<0,001). Those who were hospitalized had a significantly higher HR (p<0,05). A lower HR was found in the survivor group vs those who died (p<0.05).

Discussion           

Literature supports the hospitalization percentage (10%) and confirms that higher HR gives rise to elevated risk for hospitalization and death. However, this has mainly been studied in people with increased cardiovascular risk in hospitals. Limitations of the current study are a small sample size and possible confounders (eg infection without hospitalization).

Conclusion

HR positively correlates with hospitalization and death in persons living in NH. A negative correlation was found for saturation and death. A significantly higher HR was found in those who died or were hospitalized. Expansion of the cohort and further research on the optimization of a screening tool is foreseen within this project in order to make more profound pronouncements on the topic.