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目的 了解术前综合评估能否降低老年冠心病患者冠脉介入治疗术后3个月及6个月内非计划再入院率及门诊就诊率。方法 冠心病住院的老年患者100名，患者随机进入综合评估（CGA）组和常规治疗组。综合评估组患者根据CGA结果制定患者围手术期及出院后治疗方案，常规治疗组患者按照常规制定方案，每组又按是否接受了冠脉介入手术治疗，分为手术亚组和未手术亚组。所有患者在出院后3、6月进行电话随访，随访内容包括患者是否在出院后3、6个月因为各种原因再次入院治疗，是否因为各种不适门诊就诊。结果 无论是否接受CGA和冠脉介入手术，各组患者出院后3、6月再入院率均无明显差异。与常规治疗组患者相比，综合评估组患者出院后3个月门诊率无明显差异，出院后6个月门诊率显著降低（36%vs. 56%，P<0.05）。与常规治疗组的手术亚组患者相比，综合评估组的手术亚组老年患者出院后3个月（33% vs. 75%，P<0.05）、6个月（53% vs. 100%，P<0.01）的门诊率均显著降低。结论 术前CGA可以显著降低接受了冠脉介入手术的老年冠心病患者出院后中短期门诊率。
Objective To investigate whether preoperative comprehensive assessment can reduce unplanned readmission rates and outpatient visits within 3 months and 6 months after coronary intervention in elderly patients with coronary artery disease. Methods A total of 100 elderly patients were enrolled in the study. Patients were randomized into the CGA group and the routine treatment group. According to the CGA results, patients in the comprehensive assessment group developed perioperative and post-discharge treatment plans. Patients in the conventional treatment group were routinely prepared according to whether they received percutaneous coronary intervention or not, and were divided into operation subgroup and non-operation subgroup . All patients were followed up by telephone in March and June after discharge. The follow-up included whether the patients were re-admitted for various reasons 3 and 6 months after discharge, and whether they were outpatient visits due to various discomforts. Results Whether or not CGA and PCI were accepted, there was no significant difference in readmission rates between 3 and 6 months after discharge in all groups. There was no significant difference in outpatient rates at 3 months after discharge in the comprehensive evaluation group compared with those in the conventional treatment group, and significantly reduced at 6 months after discharge (36% vs. 56%, P <0.05). Elderly patients in the surgical subgroup of the comprehensive assessment group were significantly less likely to have an adverse effect on the general anesthesia group than those in the conventional treatment group at 3 months (33% vs. 75%, P <0.05), 6 months (53% vs. 100% P & lt; 0.01) were significantly reduced. Conclusion Preoperative CGA can significantly reduce the short-term outpatient rate of elderly patients with coronary heart disease undergoing coronary intervention.