Excess mortality for care home residents during the first 23 weeks of the COVID-19 pandemic in England: a national cohort study.
Excess mortality for care home residents during the first 23 weeks of the COVID-19 pandemic in England: a national cohort study.
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DOI：
10.1186/s12916-021-01945-2
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发表时间：
2021-03-05
期刊：
影响因子：
9.3
通讯作者：
Turner AJ
中科院分区：
文献类型：
--
作者：
Morciano M;Stokes J;Kontopantelis E;Hall I;Turner AJ
估计英格兰COVID-19大流行期间养老院居民的超额死亡率，探索与养老院特征的关联。2017年1月1日至2020年8月7日期间，英格兰所有住宿和疗养院的每日死亡人数通知护理质量委员会（CQC）。护理之家一级的数据与CQC护理之家登记册相关联，以确定家庭特征：客户类型（65岁以上/儿童和成人）、所有权状况（营利/非营利;品牌/独立）和规模（小型/中型/大型）。超额死亡数是根据大流行前的数据使用地方当局固定效应泊松回归计算的观察死亡数和预测死亡数之间的差异。使用固定效应logistic回归模型对COVID-19疑似/确诊死亡的几率进行建模。截至2020年8月7日，所有护理院有29，542人（95%CI 25，176至33，908）超额死亡。超额死亡占所有护理之家床位的6.5%（95% CI 5.5至7.4%），护理（8.4%）高于住宅（4.6%）。64.7%（95% CI 56.4至76.0%）的超额死亡病例为确诊/疑似COVID-19。几乎所有的超额死亡都发生在有任何COVID-19死亡的家庭的四分之一（27.4%）。在提供护理服务的家庭中，经历COVID-19可归因死亡的几率更高（OR 1.8，95% CI 1.6 - 2.0），老年人和/或痴呆患者（OR 5.5，95% CI 4.4 - 6.8），在较大（与小）家庭（OR 13.3，95% CI 11.5至15.4）和属于大型供应商/品牌（OR 1.2，95% CI 1.1至1.3）。这与提供商的营利性地位没有显着联系。为了限制过高的死亡率，政策应针对护理院，以尽量减少疾病进入的风险，并限制随后的传播。我们的研究结果为进一步研究机制和政策优先级提供了具体的特征目标。在线版本包含补充材料，可通过10.1186/s12916-021-01945-2获得。
To estimate excess mortality for care home residents during the COVID-19 pandemic in England, exploring associations with care home characteristics. Daily number of deaths in all residential and nursing homes in England notified to the Care Quality Commission (CQC) from 1 January 2017 to 7 August 2020. Care home-level data linked with CQC care home register to identify home characteristics: client type (over 65s/children and adults), ownership status (for-profit/not-for-profit; branded/independent) and size (small/medium/large). Excess deaths computed as the difference between observed and predicted deaths using local authority fixed-effect Poisson regressions on pre-pandemic data. Fixed-effect logistic regressions were used to model odds of experiencing COVID-19 suspected/confirmed deaths. Up to 7 August 2020, there were 29,542 (95% CI 25,176 to 33,908) excess deaths in all care homes. Excess deaths represented 6.5% (95% CI 5.5 to 7.4%) of all care home beds, higher in nursing (8.4%) than residential (4.6%) homes. 64.7% (95% CI 56.4 to 76.0%) of the excess deaths were confirmed/suspected COVID-19. Almost all excess deaths were recorded in the quarter (27.4%) of homes with any COVID-19 fatalities. The odds of experiencing COVID-19 attributable deaths were higher in homes providing nursing services (OR 1.8, 95% CI 1.6 to 2.0), to older people and/or with dementia (OR 5.5, 95% CI 4.4 to 6.8), amongst larger (vs. small) homes (OR 13.3, 95% CI 11.5 to 15.4) and belonging to a large provider/brand (OR 1.2, 95% CI 1.1 to 1.3). There was no significant association with for-profit status of providers. To limit excess mortality, policy should be targeted at care homes to minimise the risk of ingress of disease and limit subsequent transmission. Our findings provide specific characteristic targets for further research on mechanisms and policy priority. The online version contains supplementary material available at 10.1186/s12916-021-01945-2.
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影响因子：
14.6
作者：
Stall, Nathan M.;Jones, Aaron;Costa, Andrew P.
通讯作者：
Costa, Andrew P.
DOI：
10.1016/s2666-7568(20)30012-x
发表时间：
2020-10
期刊：
The lancet. Healthy longevity
影响因子：
--
作者：
Burton JK;Bayne G;Evans C;Garbe F;Gorman D;Honhold N;McCormick D;Othieno R;Stevenson JE;Swietlik S;Templeton KE;Tranter M;Willocks L;Guthrie B
通讯作者：
Guthrie B
影响因子：
6.3
作者：
Ouslander, Joseph G.;Grabowski, David C.
通讯作者：
Grabowski, David C.
DOI：
10.15585/mmwr.mm6915e4
发表时间：
2020-04-17
期刊：
MMWR. Morbidity and mortality weekly report
影响因子：
--
作者：
CDC COVID-19 Response Team
通讯作者：
CDC COVID-19 Response Team
影响因子：
15.1
作者：
Ladhani SN;Jeffery-Smith A;Patel M;Janarthanan R;Fok J;Crawley-Boevey E;Vusirikala A;Fernandez Ruiz De Olano E;Perez MS;Tang S;Dun-Campbell K;Evans EW;Bell A;Patel B;Amin-Chowdhury Z;Aiano F;Paranthaman K;Ma T;Saavedra-Campos M;Ellis J;Chand M;Brown K;Ramsay ME;Hopkins S;Shetty N;Chow JY;Gopal R;Zambon M
通讯作者：
Zambon M