進行性認知症の介護施設住人の予後予測を推定する
Susan L Mitchell1, Dan K Kiely, Mary Beth Hamel
1Hebrew Rehabilitation Center for Aged Research and Training Institute, the Harvard Medical School, Boston, Mass 02131, USA. smitchell@mail.hrca.harvard.edu
JAMA
|June 10, 2004
まとめ
進行性認知症の介護老人ホームの住人の6ヶ月の死亡率の正確な予測は極めて重要です. 最低データセット (MDS) 変数を用いた新しいリスクスコアは,既存のツールに比べて,より高い精度を示しています.
科学分野:
- ゲロントロジーはゲロントロジーの学科です.
- 緩和ケアとは,緩和ケアです.
- クリニカル・インフォマティックス
背景:
- 先進的な認知症の患者に対する正確な予後ツールは不足しています.
- 生存率を予測する難しさは,認知症患者のホスピス入院を制限する.
研究 の 目的:
- 進行性認知症の介護施設住人の6ヶ月の死亡率を予測する要因を特定する.
- この集団における6ヶ月の死亡率を予測するための実用的なリスクスコアを開発する.
主な方法:
- 最小データセット (MDS) のデータを用いた遡及的なコホート研究.
- ニューヨークとミシガン州で進行性認知症の介護施設の住人を含む.
- 6ヶ月の死亡率の12変数のリスクスコアを開発し,検証しました.
主要な成果:
- 住民の28.3% (派生) と35.1% (検証) が6ヶ月以内に死亡しました.
- 死亡率はリスクスコアが高くなり,8.9%から70.0%まで上昇した.
- 開発されたリスクスコアは,FASTスケール (AUROC 0.51) よりも予測精度が優れている (AUROC 0.74/0.70) ことが示されました.
結論:
- MDSデータから得られた12変数のリスクスコアは,進行性認知症の介護老人ホームの住人の6ヶ月の死亡率を正確に予測します.
- このリスクスコアは,現在のガイドラインと比較して,予測能力を向上させています.
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