在痴呆症的养老院居民中住院的经历
Jordan M Alpert1, Jeffrey D Kovach2, Nicholas J Casacchia1
1Center for Value-Based Care Research, Cleveland Clinic, Cleveland, OH, USA.
Journal of the American Medical Directors Association
|December 7, 2025
概括
患有阿尔茨海默氏症和相关痴呆症 (ADRD) 的养老院居民住院治疗往往导致痛苦的经历,很少有息治疗或临终关怀转诊. 患者和家人需要在入院前提供有关医院旅程和可用的支持服务的信息.
科学领域:
- 老年病的医生 老年病的医生
- 神经学 神经学
- 医疗保健管理的管理
背景情况:
- 对于患有阿尔茨海默氏症和相关痴呆症 (ADRD) 的养老院居民来说,住院是常见的,昂贵的,并且与糟糕的结果有关.
- 与其他患者群体相比,ADRD患者在住院期间患不良事件的风险更高.
研究的目的:
- 为了全面描述患有ADRD的养老院居民在医院的体验.
- 确定这群脆弱人群在住院期间的常见干预措施和结果.
主要方法:
- 对于患有ADRD的养老院居民住院的10,195次住院病例进行了回顾性分析.
- 从2013年1月到2023年7月的单一卫生系统 (俄俄州和佛罗里达州) 中的电子健康记录中提取的数据.
- 描述性统计数据用于总结患者特征,医院干预和结果.
主要成果:
- 患者的中位年龄为84岁,61%为女性,71%为白人. 平均逗留时间为5天.
- 观察到的干预率很高,其中69%需要保姆,34%需要福利导管,51%接受神经精神药物治疗. 痴呆症影响了21%,4%的人死亡.
- 将近20%的患者入住重症监护室 (ICU),干预和不良事件的发生率更高. 对息治疗 (5%),老年医疗 (2.4%) 和临终关怀 (1.1%) 的转诊不常见.
结论:
- 对于患有ADRD的养老院居民来说,入院与严重的痛苦和频繁的干预有关.
- 大多数患者缺乏做不复苏 (DNR) 命令,缓和或宿舍护理咨询很少发生,这表明生命终端护理计划中的潜在差距.
- 让患者和家人了解医院经验,并提供适当的支持性护理服务,对于改善护理质量至关重要.
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