瑞典中风后长期护理的发展轨迹:全国性研究探索模式和决定因素
Anna C Meyer1, Marcus Ebeling2, Karin Modig1
1Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
Journal of the American Medical Directors Association
|January 6, 2024
概括
卒中幸存者通常需要长期护理,但许多患有卒中的老年人甚至在他们的事件发生之前就利用了护理服务. 预先存在的需求显著影响中风后的结果和死亡率.
科学领域:
- 老年学是一门学科.
- 神经学 神经学
- 公共卫生 公共卫生
背景情况:
- 在全球范围内,中风是导致死亡和残疾的主要原因.
- 关于老年中风幸存者的长期护理使用模式的研究有限.
- 了解长期护理轨迹对于有效的中风后管理至关重要.
研究的目的:
- 为了探索中风后老年人的长期护理轨迹.
- 为了比较中风幸存者和匹配的对照组之间的护理利用模式.
- 确定影响中风后死亡率和护理途径的因素.
主要方法:
- 全国范围的前性队列研究,针对瑞典首次中风 (2015-2017年) 住院的70岁以上的个人.
- 在人口登记中进行了3年的随访,将中风患者与一般人口同龄人进行比较,并与倾向分数匹配的对照进行了跟踪.
- 多变量考克斯回归和多状态模型分析了死亡率和护理轨迹的决定因素.
主要成果:
- 确定了31560名中风患者 (平均年龄为82.9岁);他们比同龄人中风前的并发病率和护理使用率更高.
- 与对照组相比,中风患者更有可能进入长期护理,但38%的患者在没有它的情况下存活了3年.
- 性,收入,同居和并发症影响了护理轨迹;护理状态比查尔森并发症指数更好地预测死亡率.
结论:
- 卒中增加了死亡率和长期护理需求,很少有患者在护理后恢复独立生活.
- 脑卒中后护理使用和死亡率的很大一部分与先前存在的护理需求有关.
- 脑中风前护理的利用是评估脑中风预后的关键因素,应该在未来的研究中考虑.
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