Resource Use During the Last 6 Months of Life of Individuals Dying with and of Alzheimer's Disease
Resource Use During the Last 6 Months of Life of Individuals Dying with and of Alzheimer's Disease
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DOI：
10.1111/jgs.15287
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发表时间：
2018-05-01
影响因子：
6.3
通讯作者：
Annemans, Lieven
中科院分区：
文献类型：
--
作者：
Faes, Kristof;Cohen, Joachim;Annemans, Lieven
目的：比较被诊断为阿尔茨海默病（AD）但AD未被正式确定为潜在死亡原因（死于AD）的个体与AD为潜在死亡原因（死于AD）的个体在生命最后6个月内的资源使用情况。设计：全人群回顾性分析。设置:比利时。参与者：2012年所有比利时死者。测量：我们将参与者的医疗保健、人口和死亡证明数据联系起来。死于阿尔茨海默病的人是根据潜在的死亡原因选择的。死于阿尔茨海默病的人是通过一种经过验证的算法选择的。结果：死于AD的患者比死于AD的患者住院次数少；入住姑息治疗单位的次数较少，但接受姑息家庭护理服务的次数略多；并且使用了物理治疗、无创通气、医学成像、镇静剂、氧气和阿片类药物，与死于AD的人相当。结论：在生命的最后6个月，AD死亡个体使用的重症监护病房、心肺复苏和有创通气等强化资源比AD死亡个体少，这表明识别生命末期阶段的作用。总的来说，AD患者很少使用姑息治疗服务，这表明需要更多的努力来鼓励AD患者使用姑息治疗。
OBJECTIVES: To compare resource use during the last 6 months of life of individuals diagnosed with Alzheimer's disease (AD) but for whom AD was not formally identified as the underlying cause of death (dying with AD) with that of those who had AD as underlying cause of death (dying of AD).DESIGN: Full-population retrospective analysis.SETTING: Belgium.PARTICIPANTS: All Belgian decedents in 2012.MEASUREMENTS: We linked participants' healthcare, population, and death certificate data. Those who died of AD were selected based on underlying cause of death. Those who died with AD were selected using a validated algorithm.RESULTS: Individuals who died of AD had less hospital use than those who died with AD; were less often admitted to a palliative care unit but received palliative home care services slightly more often; and had use of physiotherapy, noninvasive ventilation, medical imaging, sedatives, oxygen, and opioids comparable with that of those who died with AD.CONCLUSION: During the last 6 months of life, individuals dying of AD used fewer intensive resources such as intensive care unit, cardiopulmonary resuscitation, and invasive ventilation than those dying with AD, which suggests the effect of recognition of an end-of-life phase. Overall, individuals with AD rarely used palliative care services, suggesting a need for more efforts to encourage use of palliative care in individuals with AD.