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在老年患者植入心脏转换器-除器后的临床治疗:来自国家心血管数据注册的结果
Daniel B Kramer1, Matthew R Reynolds2, Sharon-Lise Normand2
1From Hebrew SeniorLife Institute for Aging Research, Boston MA (D.B.K., S.L.M.); Smith Center for Outcomes Research in Cardiology, Division of Cardiology, Beth Israel Deaconess Medical Center, Boston MA (D.B.K.); Harvard Medical School, Boston MA (D.B.K., S.L.M.); Harvard Clinical Research Institute, Boston MA (M.R.R.); Lahey Hospital & Medical Center, Burlington, MA (M.R.R.); Department of Health Care Policy, Harvard Medical School, Boston, MA (S.-L.N.); Department of Biostatistics, Harvard TH Chan School of Public Health, Boston, MA (S.-L.N.); Center for Outcomes Research and Evaluation, Yale New Haven Hospital, Yale University, New Haven, CT (C.S.P.); Mid America Heart Institute, Kansas City, MO (J.A.S.); and Department of Health Services, Policy & Practice, Center for Gerontology and Health Care Research, Brown University School of Public Health, Providence, RI (V.M.). dkramer@bidmc.harvard.edu.
拥有可植入心脏变压器 (ICD) 的老年患者的住院率很高,近一半在五年内死亡或住院. 这突显了该群体需要息护理的准备.
科学领域:
- 心脏病学
- 老年病学
- 缓和护理
背景情况:
- 植入式心脏除器 (ICD) 的老年患者面临更高的短期死亡风险.
- 在老年死者中使用临终关怀是常见的,但对于老年ICD患者来说是未知的.
研究的目的:
- 为了确定老年人接受ICD的住院率.
- 评估与临终关怀入院时间相关的因素.
主要方法:
- 在2006年至2010年间植入ICD的65岁以上医疗保险患者的分析.
- 评估临终关怀的比例,累积发病率和时间到事件的因素.
主要成果:
- 植入后5年,50. 9%的患者已死亡或住院.
- 36.8%的死者接受了临终关怀服务.
- 年龄较大,心力衰竭较高,排泄率较低,地区性临终关怀预测临终关怀的时间较短.
结论:
- 超过三分之一的老年ICD患者在死亡前接受临终关怀.
- 一半的老年ICD患者在5年内死亡或住院.
- 息护理提供者必须为ICD患者的特殊需求做好准备.
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