在长期急症医院住院后的生存,功能和认知能力
Snigdha Jain1, Siqi Gan2,3, Oanh K Nguyen4
1Section of Pulmonary, Critical Care, and Sleep Medicine, Yale School of Medicine, New Haven, Connecticut.
JAMA network open
|May 28, 2024
概括
五分之四的老年人经历严重的功能或认知衰退或死亡在长期急症医院 (LTCH) 停留2.5年内. 住院前的健康状况显著影响了这些结果.
科学领域:
- 老年学是一门学科.
- 医疗保健服务研究 医疗服务研究
- 临床结果 临床结果
背景情况:
- 长期急性护理医院 (LTCH) 每年为超过7万名医疗保险受益人提供长期急性疾病的服务.
- 关于老年人LTCH住院后的长期功能和认知轨迹的数据有限.
研究的目的:
- 描述LTCH住院后的生存,功能状态和认知状态.
- 确定与这一群体中不利的长期结果相关的因素.
主要方法:
- 使用与医疗保险索赔相关的健康和退休研究 (HRS) 数据进行回顾性队列研究.
- 包括396名50岁以上的成年人,他们在2003-2016年期间接受了LTCH治疗.
- 结果 (死亡,严重的功能/认知障碍) 通过每两年一次的HRS访谈评估,直到LTCH后2.5年.
主要成果:
- 80%的参与者 (318/396) 在2.5年内死亡或严重损伤 (功能,认知或两者兼而有之).
- 严重的基线损伤 (28%的队列) 和较差的LTCH前生存预后 (李指数) 与不良结果有显著联系.
- 调整后的赔率比:李指数为3.2,严重基线损伤为4.5.
结论:
- 高比例的老年人在LTCH住院后面临严重的长期后果.
- 预先存在的功能/认知状态和生存预后是LTCH后结果的关键预测因素.
- 这些因素应该为长期急性疾病患者的临床决策提供信息.
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