基于医院的息治疗转诊:癌症老年人的决定因素
Alex Chanteclair1,2, Sophie Duc3, Brice Amadeo2
1Gerontology Department, University Hospital Centre Bordeaux, Bordeaux, France alex.chanteclair@chu-bordeaux.fr.
BMJ supportive & palliative care
|February 20, 2024
概括
老年癌症患者的住院息护理 (HPC) 转诊受癌症预后,功能衰退和性别的影响. 这些因素有助于预测医疗保健的旅程,以改善生活质量.
科学领域:
- 老年瘤学 老年瘤学
- 抚慰性护理是一种缓解性护理.
- 癌症流行病学 癌症流行病学
背景情况:
- 早期的息治疗可以提高老年癌症患者的生活质量.
- 了解转诊决定因素对于及时获得息治疗至关重要.
- 患有癌症的老年人面临着独特的老年和瘤挑战.
研究的目的:
- 分析影响老年癌症患者住院息护理 (HPC) 转诊的社会人口统计学,老年和瘤相关因素.
- 为了考虑到HPC转介的分析中死亡的竞争风险.
- 在老年癌症人群中确定主动HPC转诊的关键决定因素.
主要方法:
- 利用了来自三个基于人口的老龄化队列 (PAQUID,3C,AMI) 的数据,包括在2014-2018年间被诊断患有癌症的老年人.
- 采用特定原因的考克斯模型来评估10个决定因素:年龄,性别,生活状况,居住地,瘤预后,ADL/IADL限制,认知障碍,抑郁症和多药.
- 包括131名患有癌症的老年患者,其中26人接受HPC.
主要成果:
- 不良的癌症预后显著增加了HPC转诊的可能性 (HR 7.02).
- 日常生活工具活动 (IADL) 的损伤与更早的转诊有关 (HR 3.21).
- 女性在诊断后的立即转诊率更高 (HR 8.64).
结论:
- 癌症预后,功能衰退 (IADL) 和性别独立地预测了老年癌症患者的HPC转诊.
- 这些发现有助于更好地预测这个人口群体的医疗保健路径.
- 优化HPC转诊可以提高护理质量和患者的治疗结果.
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