熟练的护理设施康复强度和痴呆症患者的成功出院
Thomas A Bayer1, Lan Jiang2, Mriganka Singh3
1Providence VA Medical Center, Long-Term Services and Supports Center of Innovation, Providence, RI, USA; Warren Alpert Medical School of Brown University, Division of Geriatrics and Palliative Medicine, Providence, RI, USA.
对于因心力衰竭 (HF) 住院的痴呆症患者,熟练治疗 (ST) 显著提高了熟练护理设施 (SNF) 的成功出院率. 更多的ST小时与更好的结果相关,显示出剂量依赖的关系.
科学领域:
- 老年学是一门学科.
- 康复医学 康复医学 康复医学
- 心脏病学 心脏病学
背景情况:
- 痴呆症心力衰竭 (HF) 患者在成功出院时面临复杂的护理需求和挑战.
- 像物理和职业疗法这样的熟练疗法 (ST) 对功能恢复至关重要.
研究的目的:
- 量化熟练疗法 (STs) 与熟练护理机构 (SNFs) 在患有痴呆症 (VwD) 的退伍军人心力衰竭 (HF) 住院后成功出院之间的关联.
主要方法:
- 对因HF住院并入院SNF的VwD进行了回顾性队列研究.
- 测量每周的ST小时,并根据SNF及时退出和30天的存活率而定义成功的退院,而无需重新住院或重新机构化.
- 使用多变量回归来估计相对风险,调整混因素.
主要成果:
- 总共包括了8255个VwD;34%的VwD获得了成功的清算.
- 每周接受5.3小时或更长时间ST治疗的患者的成功出院率显着更高.
- 观察到一种剂量依赖的关系,最高的ST组显示成功出院率增加了170%.
结论:
- 熟练的疗法与在HF住院后成功从SNF释放VwD有很强的关联.
- 每周增加ST的时间似乎改善了患者的治疗结果,并减少了再入院.
- 研究结果支持将ST纳入和优化为这一群体提供医院后护理.
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