Characteristics and determinants of survival in oldest old nursing home residents admitted to hospital with an acute illness compared to their younger counterparts
Characteristics and determinants of survival in oldest old nursing home residents admitted to hospital with an acute illness compared to their younger counterparts
复制标题
与年轻居民相比，因急性疾病入院的老年疗养院居民的生存特征和决定因素
DOI：
--
复制
发表时间：
2014
影响因子：
4
通讯作者：
P. Myint
中科院分区：
文献类型：
--
作者：
K. Honney;N. Trepte;R. Parker;J. Patel;R. Mallinson;Sayed J. Sultanzadeh;J. Potter;P. Myint
背景和目的我们最年长的老年人(≥85岁)的临床问题和需求往往与年轻患者的临床问题和需求有很大的不同，而且可以说与年轻的老年患者(65-84岁)不同。随着入住养老院(NH)的虚弱高龄老人数量的增加，我们的目标是确定这一年龄段的预后指标和预后与年轻NH住院老人的差异。方法我们回顾了2005年1月至2007年12月期间NHS连续入院的所有急性医学评估单元。比较年轻(85岁)和老年(≥85岁)两个年龄组的入院预后指标和随访结果。使用控制潜在混杂因素的多元回归方法，我们比较了两组患者的住院死亡率和出院后的长期存活率。结果纳入患者116例(平均年龄84.3岁，SD 8.34岁)，其中女性占68.5%。不同年龄段的入院特征基本相似。住院死亡率在两组之间没有显著差异，即使在调整了可能的混杂因素后也是如此。剔除5%以上数据缺失的解释变量后，高龄老年患者出院后死亡的风险显著高于年轻组(HR 1.37；1.03-1.83)。结论尽管NHS的年轻患者和老年患者的入院特征相似，但有证据表明，高龄老年患者的长期生存前景较差。
Background and objectivesThe clinical problems and needs of our oldest old (≥85 years) are often substantially different from those of younger patients, and are arguably different from younger elderly patients (age 65–84). With the increasing number of frail oldest olds residing in Nursing Homes (NH), we aim to identify differences in prognostic indicators and outcomes in this age group compared to younger NH residents.MethodsWe retrospectively identified all consecutive admissions from NHs to an Acute Medical Assessment Unit between January 2005 and December 2007. Admission prognostic indicators and outcomes at follow-up were compared between younger (<85) and older (≥85) age groups. Using multiple regression methods controlling for potential confounders, we compared in-hospital mortality and long-term survival after discharge between the groups.ResultsThree hundred and sixteen patients (mean age 84.3, SD 8.34 years) were included (68 % females). Admission characteristics were mostly similar between age groups. In-hospital mortality rates were not significantly different between groups, even after adjusting for possible confounders. Oldest old patients had a significantly greater hazard of dying after discharge (HR 1.37; 1.03–1.83) compared to the younger group after removing explanatory variables with more than 5 % missing data.ConclusionWhilst the admission characteristics are similar between younger and older patients from NHs, there is evidence to suggest worse long-term survival prospects for oldest old patients.