帕金森病患者生命末期的医疗保健利用率:基于人口的注册研究
Breiffni Leavy1,2, Elisabet Åkesson3,4, Johan Lökk5,6
1Division of Physiotherapy, Department of Neurobiology, Care Science and Society, Karolinska Institutet, Stockholm, Sweden. breiffni.leavy@ki.se.
BMC palliative care
|October 29, 2024
概括
帕金森病 (PD) 患者的终身护理显示了高的急诊室访问和医院死亡. 专门息治疗 (SPC) 的转诊率很低,突出了差异和需要更好地基于脆弱性的护理规划.
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:
- 关于帕金森病 (PD) 的生命终端医疗保健利用情况的数据有限.
- 了解急诊室 (ER) 访问,专业息治疗 (SPC) 接收和急性医院死亡的模式对于改善护理至关重要.
研究的目的:
- 在瑞典基于人口的PD队列中调查生命终端医疗保健的使用情况.
- 为了确定与急诊室访问,SPC接收和急性医院死亡相关的因素.
主要方法:
- 在斯德哥尔摩地区从2015年到2021年对922位已故PD患者 (≥18岁) 的回顾性队列研究.
- 用单变量和多变量逻辑回归分析医疗保健提供者的数据.
主要成果:
- 大约50%的PD患者在生命的最后一个月接受了急救诊所的访问,脆弱性显著预测了这些访问 (aOR,3.90).
- 只有13%的人在过去三个月接受了SPC,与虚弱相关 (aOR,2.65).
- 31%的人在急性医院死亡;虚弱和男性性别与医院死亡有关 (aOR分别为3.70和1.90).
结论:
- 在这个PD队列中,观察到急救诊所和医院死亡率很高.
- 尽管疾病负担很高,但SPC的转诊率很低.
- 性别差异和脆弱对终身护理的影响需要针对性干预,以实现最佳的PD患者管理.
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