Hospital Admissions Associated With Cancer Pain in Older Adults With and Without Dementia.
Hospital Admissions Associated With Cancer Pain in Older Adults With and Without Dementia.
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DOI：
10.1016/j.pmn.2021.01.018
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发表时间：
2021-08
影响因子：
1.7
通讯作者：
Muench, Ulrike
中科院分区：
文献类型：
--
作者：
Strassels, Scott A.;Moss, Karen O.;Mallow, Peter J.;Tamer, Robert M.;Monroe, Todd B.;Williams, Nicole O.;Levine, Ann S.;Muench, Ulrike
肿瘤相关疼痛的治疗往往不够理想，造成了本可避免的痛苦，并增加了医疗资源的使用和成本。我们假设痴呆可能导致美国因肿瘤相关疼痛住院的患者资源使用和费用增加。研究癌症和痴呆症患者与非痴呆症患者相比如何使用美国医院的医疗资源和支出。本研究采用回顾性队列研究。2012-2016年因肿瘤相关疼痛入院的美国医院数据来自2012-2016年全国住院患者样本（NIS）。样本包括60岁或60岁以上的住院患者，主要诊断为肿瘤相关疼痛。痴呆的定义采用国际疾病分类，第九版，临床修改（ICD-9-CM）和ICD-10-CM诊断代码。主要结局是入院次数、费用和住院时间（LOS）。使用描述性统计和多变量回归模型来检验痴呆、成本和LOS之间的关系。在12034例因肿瘤相关疼痛入院的患者中，136例（1.1%）诊断为痴呆，11898例（98.9%）未诊断为痴呆。在入院的痴呆症患者和非痴呆症患者中，便秘分别占13.2%和24.5%。痴呆患者的平均生存时间为4天，非痴呆患者为3天。非痴呆患者每次入院的平均费用较高（10,736美元对9,022美元，p = 0.0304）。在调整后的回归结果中，成本增加与非选择性入院和较长的LOS有关，成本下降与年龄高于平均水平有关。相比之下，LOS下降与年龄高于平均水平和非选择性入院有关。痴呆与两个终点都没有关联。本研究为护士和其他医疗保健专业人员提供了数据，以进一步探索改善痴呆患者和非痴呆患者癌症疼痛管理的机会，从而优化医疗资源的利用。
Neoplasm-related pain is often suboptimally treated, contributing to avoidable suffering and increased medical resource use and costs. We hypothesized that dementia may contribute to increased resource use and costs in patients hospitalized for neoplasm-related pain in the United States. To examine how persons with cancer and dementia use medical resources and expenditures in US hospitals compared to ondividuals without dementia. This study examined a retrospective cohort. Admissions to US hospitals for neoplasm-related pain from 2012–2016 Data were obtained from the 2012–2016 National Inpatient Sample (NIS). The sample included hospital admissions of individuals aged 60 or older with a primary diagnosis of neoplasm-related pain. Dementia was defined using the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM), and ICD-10-CM diagnosis codes. Primary outcomes were number of admissions, costs, and length of stay (LOS). Descriptive statistics and multivariable regression models were used to examine the relationships among dementia, costs, and LOS. Of 12,034 admissions for neoplasm-related pain, 136 (1.1%) included a diagnosis of dementia and 11,898 (98.9%) did not. Constipation was present in 13.2% and 24.5% of dementia and nondementia admissions, respectively. The median LOS was 4 days in persons with dementia and three in those without. Mean costs per admission were higher in persons without dementia ($10,736 vs. $9,022, p = .0304). In adjusted regression results, increased costs were associated with nonelective admissions and longer LOS, and decreased costs with age above the mean. In contrast, decreased LOS was associated with age above the mean and nonelective admissions. Dementia was associated with neither endpoint. This study provides nurses and other health care professionals with data to further explore opportunities for improvement in cancer pain management in patients with and without dementia that may optimize use of medical resources.
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影响因子：
14
作者：
通讯作者：
--
影响因子：
8.1
作者：
Blomqvist, K;Hallberg, IR
通讯作者：
Hallberg, IR
影响因子：
3
作者：
Elixhauser, A;Steiner, C;Coffey, RN
通讯作者：
Coffey, RN
影响因子：
3.1
作者：
Griffioen, Charlotte;Husebo, Bettina S.;Achterberg, Wilco P.
通讯作者：
Achterberg, Wilco P.
影响因子：
1.7
作者：
Herr, Keela;Coyne, Patrick J.;Manworren, Renee C. B.
通讯作者：
Manworren, Renee C. B.