日本急性心力衰竭的老年患者的退院后功能结果:长寿改善和公平证据研究
Nobuhiro Narii1, Tetsuhisa Kitamura1, Atsushi Hirayama2
1Environmental Medicine and Population Sciences, Department of Social and Environmental Medicine, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan.
Age and ageing
|July 18, 2024
概括
老年急性心力衰竭患者在住院时需要更高的护理,在出院后死亡风险增加. 护理需求往往会变得更糟,这突出了对这一弱势群体的退院后支持的关键差距.
科学领域:
- 老年学是一门学科.
- 心脏病学 心脏病学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 医院护理需求水平与老年急性心力衰竭患者的结果之间的关系未得到充分研究.
- 评估护理需求对于预测老年心力衰竭患者出院后的发展轨迹至关重要.
研究的目的:
- 调查急性心力衰竭 (aHF) 的老年患者住院时的护理需求水平 (CNL) 与出院后的结果 (包括死亡率) 之间的关联.
主要方法:
- 一项基于人口的队列研究利用了医疗保险索赔和CNL数据.
- 包括在2014年4月至2022年3月期间因aHF住院的65岁以上的患者.
- 评估了护理需求水平 (NCN,SL&CNL1,CNL2-3,CNL4-5),并使用Cox比例危险模型追踪出院后一年的结果 (CNL变化,死亡).
主要成果:
- 在17724名患者中,最初的CNLs有所变化,大多数患者在出院后出现了更严重的护理需求.
- 与无护理需求 (NCN) 相比,住院时的CNL较高显著增加了出院后一年因任何原因死亡的风险.
- 死亡危险比为1.19 (SL&CNL1),1.88 (CNL2-3) 和2.56 (CNL4-5),表明护理需求和死亡风险之间存在剂量反应关系.
结论:
- 老年急性心力衰竭患者在住院时需要较高的护理,在出院后的第一年内,所有原因的死亡风险显著增加.
- 调查结果强调,需要加强医院出院后的护理策略,以适应这一人口群的护理需求水平.
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