在患有痴呆症的住院老年人中使用食管
Anne-Marie Hartford1, Wenshan Li2, Danial Qureshi3
1School of Rehabilitation Therapy, Queen's University, Kingston, Ontario, Canada.
JAMA network open
|February 20, 2025
概括
在住院痴呆症患者的输卵管放置并没有改善存活率或结果. 影响管道使用的因素往往与最佳实践相矛盾,突出需要更好的临床协议和沟通.
科学领域:
- 老年医学 老年医学
- 神经学 神经学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 痴呆症是输卵管安置的禁忌,但指导方针被不一致地遵循.
- 影响痴呆症患者输卵管使用的因素尚不清楚.
研究的目的:
- 确定住院的老年痴呆症患者中输食管的发生率.
- 分析与输卵管放置相关的健康结果.
- 为了确定与输入管插入相关的因素.
主要方法:
- 基于人口的回顾性队列研究,使用加拿大安大略省 (2014-2018) 的相关行政数据.
- 包括在住院之前被诊断患有痴呆症的老年人 (≥65岁).
- 分析了社会人口统计特征,健康状况,功能状态和高级指令.
主要成果:
- 在143331名患有痴呆症的老年人中,0.9%接受了输卵管.
- 输卵管接受者住院时间更长,ICU入院率更高,住院死亡率增加.
- 在出院后的一年内,50%的输卵管接受者死亡,而非接受者为28.4%.
- 吞问题和功能障碍增加了使用输卵管的几率,而女性性别,年龄较大,DNR指令和农村生活降低了几率.
结论:
- 在住院痴呆症患者中,输入输送管并没有与改善生存或出院后的结果有关.
- 与输卵管放置相关的因素有时与临床指导方针不一致.
- 建议:加强护理讨论的目标,替代干预措施和改进的临床协议.
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