Emergency and post-emergency care of older adults with Alzheimer's disease/Alzheimer's disease related dementias.
Emergency and post-emergency care of older adults with Alzheimer's disease/Alzheimer's disease related dementias.
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DOI：
10.1111/jgs.17833
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发表时间：
2022-09
影响因子：
6.3
通讯作者：
Grudzen, Corita R.
中科院分区：
文献类型：
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作者：
Hill, Jacob D.;Schmucker, Abigail M.;Siman, Nina;Goldfeld, Keith S.;Cuthel, Allison M.;Chodosh, Joshua;Bouillon-Minois, Jean-Baptiste;Grudzen, Corita R.
急诊科 (ED) 是痴呆症患者 (PLwD) 护理的关键环节，因为他们的入院率、急诊科复诊率和随后的住院率都很高。我们比较了 PLwD 的 ED 处置情况与患有非痴呆慢性病的老年人的情况，以及医疗保健的利用和生存情况。医疗保险索赔数据用于识别 2014 年 1 月 1 日至 2018 年 12 月 31 日期间来自 34 家医院的患有阿尔茨海默病/阿尔茨海默病相关痴呆 (AD/ADRD) 或非 AD/ADRD 慢性病的社区居住的 66 岁以上老年人。我们比较了首次就诊时的急诊处理情况，以及首次急诊就诊后 12 个月内的医疗保健利用率和死亡率，并进行了调整年龄、性别和死亡风险。 AD/ADRD 样本中有 29,626 名患者，比较样本中有 317,046 名患者。 AD/ADRD 样本年龄较大（82.4 岁（SD：8.2）与 76.0 岁（SD：7.7）），并且女性患者较多（59.9% 对 54.7%）。 AD/ADRD 样本更有可能经历急诊科急诊处理（OR 1.039，p<0.001，95% CI 1.029 – 1.050），进行急诊科复诊（OR 1.077，p<0.001，95% CI 1.066 – 1.087），并在随后的 12 个月内住院（OR 1.085，p<0.001，95% CI 1.075 – 1.095）。两个样本中 ED 对临终关怀的处置率都很低 (0.2%)。与无 AD/ADRD 的患者（12 个月内 15.3%）相比，AD/ADRD 患者的死亡风险较高（OR 1.099，p<0.001，95% CI 1.091 – 1.107），且短期死亡率较高（12 个月内 31.9%）。去急诊室就诊的 PLwD 的短期死亡率很高。尽管如此，紧急护理、急诊复诊和住院治疗，而不是临终关怀，仍然是主要的护理服务模式。 PLwD 直接从急诊室转入临终关怀机构的情况很少见。
The emergency department (ED) is a critical juncture in the care of persons living with dementia (PLwD), as they have a high rate of hospital admission, ED revisits, and subsequent inpatient stays. We examine ED disposition of PLwD compared to older adults with non-dementia chronic disease as well as health care utilization and survival. Medicare claims data were used to identify community-dwelling older adults 66+ years old from 34 hospitals with either Alzheimer’s Disease/Alzheimer’s Disease Related Dementias (AD/ADRD) or a non-AD/ADRD chronic condition between January 1, 2014 and December 31, 2018. We compared ED disposition at the index visit, as well as healthcare utilization and mortality in the 12 months following an index ED visit, and adjusted for age, gender, and risk of mortality. There were 29,626 patients in the AD/ADRD sample, and 317,046 in the comparison sample. The AD/ADRD sample was older (82.4 years old (SD: 8.2) versus 76.0 years old (SD: 7.7)) and had more female patients (59.9% versus 54.7%). The AD/ADRD sample was more likely to experience ED disposition to acute care (OR 1.039, p<0.001, 95% CI 1.029 – 1.050), to have an ED revisit (OR 1.077, p<0.001, 95% CI 1.066 – 1.087), and an inpatient stay in the subsequent 12 months (OR 1.085, p<0.001, 95% CI 1.075 – 1.095). ED disposition to hospice was low in both samples (0.2%). AD/ADRD patients had a higher risk of mortality (OR 1.099, p<0.001, 95% CI 1.091 – 1.107), and high short-term mortality (31.9% within 12 months) than those without AD/ADRD (15.3% within 12 months). PLwD who visit the ED have high short-term mortality. Despite this, disposition to acute care, ED revisits, and inpatient stays, rather than hospice, remain the predominant mode of care delivery. Transition directly from the ED to hospice for PLwD is rare.
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影响因子：
7
作者：
Olivari, Benjamin S.;French, Molly E.;McGuire, Lisa C.
通讯作者：
McGuire, Lisa C.
DOI：
10.1016/j.jamda.2021.09.016
发表时间：
2022-04-27
影响因子：
7.6
作者：
Burke, Robert E.;Xu, Yao;Ritter, Ashley Z.
通讯作者：
Ritter, Ashley Z.
影响因子：
2.9
作者：
Grudzen, Corita R.;Shim, Deborah J.;Young-Brinn, Angela
通讯作者：
Young-Brinn, Angela
影响因子：
--
作者：
ElBestawi, Marilyn R;Kohm, Catherine
通讯作者：
Kohm, Catherine
DOI：
10.19981/j.CN23-1581/G3.2024.34.012
发表时间：
2024-12-08
期刊：
科技创新与应用
影响因子：
--
作者：
李国善
通讯作者：
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